I don't use the wheel at all. It's a nice thing as are all the buttons but the BIG problem is that I have my left hand on the keyboard and my right hand on the pen, so I am using keyboard shortcuts. So the tablet side buttons never get used. Instead I just use the OLEDs to spell out amusing reminders and stuff. =P

Also mine is the Intuos 4 medium. For me it is just right. I have not tried a larger tablet. And it is only pen. There's no touch stuff and I don't think I'd use it anyway. I did note that Wacom offer an Intuos 5 pen only. Probably for people like me.