I also use the Wacom Intuos 4 medium. The new Intuos 5 is out now with even more features (but you may find a good deal on the Intuos 4 being the older model). You could go for the small size and save some money but that's a personal choice and remember it's an investment you'll get a lot of use from.

Hey, thanks for the suggestions. I would love to get an intuous4... but I dont think I can afford it at this point. so.. does anyone have a Bamboo Create? I know they're pretty new... but i'd like to get a first-hand opinion on one. thanks!

We had one for Beta testing at the Art Studio I work for. The new Bamboo Create is a big step up from the older version, better control, larger work surface and even has the new multi-touch feature which is pretty cool. I had been using an older Intuos 3 (until I upgraded to the Intuos 4), the Bamboo Create has a better feel than the older Intuos version, I would say you won't be disappointed, it's your best option over any other brands.
Let us know what you decided and share your thoughts so others can benefit as well!

You may have seen this but if not check out the video demonstration!

I have two, a intuos 4 large and a wacom graphire 3, I use the graphire almost exclusively
I only use the mouse on either but the graphire mouse seems for me to be the best for control