For about 5 years I drove a dually, crewcab, longbed pickup daily in to and out of Downtown Los Angeles.
Never had a problem with parking...I usually parked in a parking structure but from time to time would park on the street or in a parking lot when visiting clients.  It was great at Hotels because the valet would have to park it next to the Rolls Royces, Mercedes, Ferraris out front of the hotel.
On the freeway you get a commanding view of the traffic which makes for a safer drive plus it's so big other drivers tended to get out of my way.
It's like anything else, you get comfortable with the size after a few days of driving it.