do the pen nibs wear out quickly?

I've used a couple of surface sheets in my 7 years using Wacom products - the rougher side apparently results in more wear than the standard or smooth papers. That said, I feel like it will be years before I come close to running out of the provided nibs since it's once every many months - if not more - that I notice wear on my nib. A note: I use Wacom as an all-day, mouse replacement. So, I'm constantly using it (you can sort of see where the scroll bar is on my tablet). While I am regularly using the nib, I'm not doing a lot of fill-in or illustration so it may be those drawing / painting more with it see wear more quickly. Tl;dr - There's nib wear, but my workload has at least 2 nibs / year lasting. If I needed a rougher surface to enjoy the pencil-on-paper feel, expect to trade off that feeling for reduced wear.

Does it come with extra nibs?

I assume, by nibs, you mean pen tips? If so, then yes, there are several inside the pen base. Basically, you unscrew the bottom of the pen base to take it a part and there are several extra pen tips in side of it.

Is this tablet compatible with Windows 10?

Yes. Currently using it with Windows 10 Anniversary Edition and Photoshop CC 2017 without issue.

I'm a lefty, can i use the tablet with the controls on the right side? ie upside down i guess

Yes, I'm a lefty and use it just fine. You can flip the controls under mapping in the settings. You can't just turn it upside down or your lines will go the wrong way

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✍️ Elevate your digital canvas with pro-level precision and wireless freedom!

ERGONOMIC PRO PEN 2 - Battery-free, tilt-sensitive pen designed for hours of fatigue-free creativity.
BONUS CREATIVE SUITE - Get 3 months of Capture One and MASV file transfer to elevate your professional projects.
CUSTOMIZABLE EFFICIENCY - 8 ExpressKeys and multi-touch gestures tailor your workflow for maximum productivity.
SEAMLESS WIRELESS WORKFLOW - Bluetooth connectivity frees your workspace from cables, boosting creative freedom.
UNMATCHED PRECISION CONTROL - Experience ultra-responsive 8192-level pressure sensitivity for flawless digital artistry.

The Wacom Intuos Pro Medium is a sleek, Bluetooth-enabled graphics tablet featuring the advanced Pro Pen 2 with 8192 pressure sensitivity and tilt recognition. Designed for Mac and Windows professionals, it offers 8 customizable ExpressKeys, multi-touch gestures, and a compact form factor to streamline creative workflows. Included software trials add immediate value for image editing and file transfer.

Standing screen display size	132
Screen Resolution	1920x1080
Number of USB 2.0 Ports	1
Average Battery Life (in hours)	1 seconds
Brand	Wacom
Series	Wacom Intuos Pro, Medium, Black (PTH660)
Item model number	PTH660
Hardware Platform	Mac, PC
Operating System	Windows
Item Weight	1.54 pounds
Product Dimensions	8.6 x 13.3 x 0.1 inches
Item Dimensions LxWxH	8.6 x 13.3 x 0.1 inches
Color	Black
Rear Webcam Resolution	0.1 MP
Batteries	1 A batteries required. (included)
Manufacturer	Wacom Technology Corporation
ASIN	B01MQU5LW7
Is Discontinued By Manufacturer	No
Date First Available	January 5, 2017

Wacom Intuos Pro Medium Bluetooth Graphics Drawing Tablet, 8 Customizable ExpressKeys, 8192 Pressure Sensitive Pro Pen 2 Included, Compatible with Mac OS and Windows,Black

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