Wow, I didn't think using the pinkie could be uncomfortable, actually thought it would be the most pleasant way of playing. Gonna have to get used to it eventually, but right now I can't react at all with those fingers if I use four at once, add muscle tension to that and it's downright bothersome.
Yeah, it'll probably go away as I get used to it, no bother.
Gotta advertise controllers though (since you barely hear anything good about them) - using "c" was never an issue with it, no, it was downright intuitive. Then again, ZUN provided the opportunity to remap controller-buttons without having to resort to another program that tricks the computer and thus game into thinking that a key is different from what it actually is; which might lead to problems (though not for everyone so do as Zengeku says, personally I don't want to mess with it anymore - my computer doesn't seem to like it).
I care because it is hard to get some of the later extends otherwise.
Therefore, you actually care about survival and not points. I don't know if 50 million is the last extend (then again never exceeded 70 million so there might be), but some people get over 100 million so they clearly have a goal aside survival.