Contrary to the Exxxtenz advertising campaign, sometimes smaller is actually better. Take that PDF roll of client documents you just scanned or all those deposition transcripts. Wouldn't it be nice to have enough room in the margins to make fail-safe, "don't skip this, stupid" annotations (either by hand or with PDF-Xchange Viewer)?
Thanks to modern technology, you can get smaller immediately, and without the aid of high-priced pills or Swedish-made suction devices. If you have an existing PDF file, just reprint it using CutePDF, but scale down your print size to about 75-80%. That will leave plenty of room in the margins for you to make your big, bold notes (and hopefully reduce the need to do document or deposition summaries).
The little blurbs you can make with Adobe or PDF-Exchange Viewer are nice. Actually making the notes within the printable space on the document, however, means no one will miss the boat as a result of being unfamiliar with your .pdf software.