Can you see both of them? The optic neuro might be able to detect and maybe even help with some managment suggestions.
The MS clinic in Boston, even with the interns would most likely offer a more comprehensive assessment and plan for all that you are facing. The MS clinic I go to has physios, occupational therapists, nurses and social workers who specifically offer help with MS.
I think that it is worth seeing who ever might be able to more clearly identify specifics for us; even though it is tiresome. Maybe they will look into Devic's Disease for you as well. That's where I'm at now and have been told that the management of that is different than for MS.

When I need to go to a major city and don't trust my driving once there, I find that taking a hotel on the edge of the city and taking a cab or bus from there to where ever I need to go helps to ease the stress. You might try calling the MS clinic in Boston before hand to find out if they have a social worker to help you get around. The MS clinic where I go offers that and they can also arrange for low cost accommodations that are specifically for out of town patients (Easter Seal House).

I hear you on the gastic side effects and medication issues. It is definitely a problem; and sort of a balancing act between trying not to send the GI tract into a tail spin and getting some relief of other symptoms with medication. Most medication also affects my hypothyroidism as well.

Take it a day at a time...sometimes its all that we can do.
With love, Erika