This Is MS Multiple Sclerosis Community: Knowledge & Support

These observations suggest that the course of progression in MS was independent of relapses either preceding it or superimposed on it,4 a dissociation that has led to the suggestion that PPMS may simply be MS with the common relapsing–remitting phase “amputated.”3,5

For the entire cohort, mean age at PPMS onset was 38.5 years, a full 10 years later than the mean for RRMS.3

For the entire cohort, mean age at PPMS onset was 38.5 years, a full 10 years later than the mean for RRMS.3 However, mean age at onset of progression in the general MS population was 38–40 years,2 indicating that later onset of PPMS could be attributed largely to the absence of a relapsing–remitting phase. Similarly, progression occurred more rapidly in PPMS compared with SPMS when measured from disease onset, but progression to Disability Status Scale (DSS) 6 and DSS 8 was actually more rapid in SPMS patients when rate of progression was measured from onset of progression. Rate of progression to DSS 10 (death) did not differ between PPMS and SPMS.3 These observations suggest that the course of progression in MS was independent of relapses either preceding it or superimposed on it,4 a dissociation that has led to the suggestion that PPMS may simply be MS with the common relapsing–remitting phase “amputated.”3,5

Or maybe like me the rrms phase is treated as "attention seeking behaviour" and you begin to think that you are a hypochondriac, so stop even going to the doctor.