Hairball...I too have really bad hands, arthritis and some carpal tunnel. I've been used to using the GGTS and also the Precise 18650 and now have had my hands on my Provari since yesterday afternoon. All three are heavy mods and require not only a good grip, but a certain angle to press the button. Of all three, I still think the GGTS is the easiest to hold and use, both due to the weight(it's aluminum) and the lower position of the button. The Precise is the hardest for me, as the "slimmer" design is really not as comfortable and the bottom button requires a good deal of pinky strength. Having said that, I'm really getting used to my Provari now finally. I've tried every imaginable angle to try and get it to function as cleanly as the GGTS. The advantage of the Provari is that the button is very easy to press and the slotted grooves along the tube really do help the grip a lot. So here is what I do and it works very simply and feels as comfortable as the GGTS. I grip the Provari fully and place the button just under the first joint in my index finger. I can then just kind of give it a squeeze to fire the button. The thumb rests perfectly behind the button and gives it stability as you vape. This is very, very comfortable to hold and use this way. Hope that maybe this will help you some.