As previously mentioned, there's no way to prevent melee from breaking follow. :P

Once you get used to it, you should be able to go through an entire fight without having to reposition except when some mobs die. I tend to run up just to the side of mobs so the alts break follow on first hit and are in range, then I just turn my main 90 degrees and go to town.

Regarding macros, aside from shocks/instances/debuffs/totems/etc. (which are the same macros you'd use for elemental or otherwise) I basically spam two macros as needed:

1) my "/follow focus" macro
2) My enhancement shammy combat macro, which looks like this:

/assist focus
/stopmacro [noharm]
/startattack
/cast stormstrike


Worked very well for me.