Hi - I was dignosed with MS in 1991 and only earlier this year that diagnosis was refined to PPMS. In 20 years the degeneration has been quite steady but quite slow. I hope this is some help to you. There's no remission but at least you know where you are with it! I don't take any "MS" drugs but occasionally take Baclofen. Typically I have few lesions, no optic problems and no cognitive difficulties but walking is pretty rotten now - ataxic and tiring. No wheelchair but always two crutches or a walker and very cautiously because the gait is ataxic. On the plus side though - I enjoy my life because PPMS gives you the chance to adapt slowly. For example, I used to ride horses but now a drive a little pony; I used to be a musician but now am a local historian - these changes take time and PPMS does give you the time.   I don't try to push myself physically too much or worry too much about what cannot be changed; it's important to stay in the normal weight range; I have a weekly massage which helps spasms; I can drive a car and I do the admin for our business so have enough real work. Sometimes it is the loss of employment which is more devastating than anything else.   My attitude to PPMS has been to live with it, move round the bits I cannot do any more and not regret the loss too much because it doesn't help at all.    PS I am now 56 and was diagnosed when I was 36.