Go faster/slower as the case may be.

Going downhill isn't so much of an issue. I can still hit 40 mph+ on the downside of a hill, but I have to work hard for it now. Last time I did it, I had to push my cadence up into the 110 rpm+ zone. There's one hill I ride regularly that has me wishing for a 53.

Turns out that losing the really small gears wasn't as bad as I originally thought. With the old gearing, once I dropped into the small gears, I was pretty much committed to staying in them or putting a lot of effort into getting out them them. Now there is a smoother transition into my smallest gears so I find I don't rely on them quite as much.