I suggest getting one of these
http://gizmodo.com/assets/resources/...n52te-1web.jpg
in addition to some sort of multi-button mouse. I use a Mx518.
Then map all of your most used and crucial abilities to the buttons most accessible to your thumbs and pointer fingers. As a child of the playstation generation these are by far my most responsive fingers. Also, id suggest removing the knob from the D pad on the nostromo.
It takes a little while to get used to the nostromo but once you do, you'll wonder how you ever did without it. =)