I generally avoid unique active items b/c it's a pain to keep track of cd's and click b/c they the icons are so tiny, is there a way to make em bigger or anything?

You can use hotkeys 1-6 to use active items. You can also rebind those to custom keys of your choice.

There is an enlarge UI option which is accessible in-game.

Your best bet is to use comfortable hotkeys to use them with, and the more you use them [activated items] the easier it will become to tell if they're off cd or not.

Rebind slot X to 'T'. Your abilities are now QWERTDF. Easy.