I had no question after reading some that I was PPMS. To give my doctor credit, Doctors usually will not DX PPMS as Insurance companies will not pay for meds. not proven to work on PPMSers or on anecdotal histories. After I failed to respond to Rebif, my doctor wrote down officially PPMS. We both knew it. He went on to become head of the MS center at Johns Hopkins. I'm proud of him. My new doctor is young, but is a great listener. We don't agree on everything but are respectful to each other. (well, I did kind of yell at him in an e-mail but we never talk about it. Jeez, I could be his mother)