Late to the party, but yes, I use and adore my Wacom Intuous4. Takes a good bit to get used to it -- and a good bit to get the various controls programmed to your liking. Terrific piece of design.
I use it with Aperture for everything.
I also sketch with it. Also delightful.
I still use a mouse, however -- they complement each other. Recommend any high-res mouse. I use the Razer Naga.