I don't understand how hard it is to put thumb buttons next to my bloody thumb.
The (wired) Mad Catz Rat MMO 7 has good thumb buttons - five plus a dpad that are all usable with only a slight twitch from my thumb's natural resting place, and still allows lifting the mouse without pressing any of them.
The wheel is shite, the feet pick up dust too easily, the DPI switcher broke too easily, and sometimes it decides to send a double-click for the LMB - but it's still better than all the alternatives.