gonats, I'm a 43 year old woman and have had PPMS since I was 8 years old. How can that be, right? I also live in the Washington DC area.  I wear Bioness devices on both legs to walk, get Botox injections in both legs every 90 days, take lg amts of Nuvigil to give me energy to walk and exercise everyday until I physically cannot exercise anymore. Everyday. I'm so afraid that if I were to stop the daily exercise my progession will increase. Talk about motivation! I'm interested in finding out more about the neurologists you refer to in your post who are not afraid to try different treatments. I have seen several neurologists in Bethesda and at the NIH, but none that really thought out of the box. I totally agree with your statement "Be optimistic. There is really no other choice." A positive perspective on PPMS can make your day become tolerable from intolerable. I have had PPMS for so long I do not remember not having it. I am married, have 2 kids (pregnant twice with PPMS but have 2 healthy kids) and worked up until 13 years ago as a senior accountant.  I will NOT allow this thing that has taken over my body to destroy my life.