Amen! Multibutton/gamer mice no longer work for me - mouse usage exacerbates my computeritis whereas trackballs hurt much less - but the more buttons the better.

for trackball 4 buttons is a minimum.

(Kensington expert mouse trackball has four buttons (+2  if you count pressing both lower or both upper buttons at the same time),  and a scroll ring.    I really wish that Kensington still sold the Kensington turbo ball,  which had similar for buttons,  plus a scroll wheel the could also be clicked for a total of five or seven buttons depending on how you count them. sometimes I just  put a numeric keypad next to the trackball, but I find that any movement of my forearm,  or worse reaching, exacerbates the computeritis.)

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My personal BKM (best known method) for such multi button devices is NOT to use the software provided by the vendor, except to map each key to unique codes and then use AutoHotKey to do fancier mapping. AutoHotKey often has much more intelligence with regards to context sensitivity and apps and the vendor software does. Doesn't look as fancy. I use vendor software mostly to set up those unique mappings, and to control the LEDs. I find it quite useful to have the colors give me an idea of what the current mapping is. Although unfortunately my current trackball does not have LEDs under the keys or buttons the way so many gamer devices do.

Plus, since I always do AutoHotKey keyboarding mappings as well as trackball remapping, and at times have had as many as five devices that I'm doing such remapping for (1) keyboard, (2) gamer mouse, (3) gamer joystick with lots of buttons, (4,5) two X-keys - I find it helps to manage everything in the same place in AutoHotKey is much as possible.

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BTW, I like your term "Mic+Mouse" workflow. When I restarted using Dragon I felt a bit of a failure because I just cannot get used to using things like mouse grid, or even "show numbers". But now I realize that while I have the ability to use a pointing device like a trackball, I might as well take advantage. I have been meaning to write a manifesto about hybrid usage models like speech recognition plus mouse/trackball. "Mic+mouse" is n nice way of putting it. although I can imagine it extending to gesture recognition, gaze tracking, etc..

DPG15.6 (also DPI 15.3) + KB, Sennheiser MB Pro 1 UC ML, BTD 800 dongle, Windows 10 Pro, MS Surface Book 3, Intel Core i7-1065G7 CPU @ 1.3/1.5GHz (4 cores, 8 logical, GPU=NVIDIA Quadro RTX 3000 with Max-Q Design.