When it comes to air consumption, my husband is a Hummer and I am a Prius. So often as his air gets around 1000psi we share air, since it's really frustrating to pay extra for Nitrox and get back on the boat with over 2000 psi left. Since we swim side-by-side, the octo hose is either wrapped around his head or mine, depending on which side I swim. I bought a 4 foot Miflex octo hose, but it still is awkward, but if we had an octo that had the hose coming off the left side it would work better. I guess an easier solution would be to buy yet a longer hose....
Other than swapping the genders we do the same deal. With the alternates on the left it works like a charm. This way it presents perfectly to a dive on the left and to one face to face. Outside of the US and in some regions it is a very common configuration despite US agency dogma.
With a little practice you can get to the alternate just fine.
Pete