Why can't I manage all these buttons

[Mhaeric]

You could use something like what I use for menu bars, which copies entire hotbars over top of my main one. I set all my desired actions on hotbars 7-10 (using jobs like BTN, MNR, etc to keep it easy to remember where they are) and then use a copy command from a macro to copy them to hotbar 6 whenever I want to display a specific set. Hotbar 5 is my "main menu" that has all of the swap macros. This could be adapted to work for your main hotbar to swap several skills as they cycle through a comba, but it would be a lot of work and comes with several drawbacks. E.g. if you got off track in your combo it would take extra button presses just to get back to the start of it. There also isn't a way to copy single hotbar skills, you have to copy the entire bar. So whenever you wanted to make a change to your hotbar you would have to go into your stored ones and make the changes there, making sure to change every single hotbar to include the same static skills. While I make great use out of this for keeping my non-combat hotbar with a very small footprint, I wouldn't really recommend it for combat hotbars. If you do decide to do it, here is a video I used to help me wrap my head around it: https://www.youtube.com/watch?v=LYToDRSELLI

I don't know the details of your coordination issues, but I suspect you might get better use out of a mouse or other controlling device if that's affordable for you. There's usually enough buttons on one of those to cover all of your needs without needing to do alt- or shift- versions of things.