I'm using a combination:
  • Button mashing for trash/non-elites.
  • /castsequence for the beginning of boss fights.
  • Merged DoT/debuff buttons
  • Hitting lots of buttons every 1.5 seconds for misc. lol
I keep myself sane by organizing everything into pages of 20 by function (dps/heals/healself/cc/misc) and using macros/infinibar to show the icons of the spells on the alts on the main's bars.