It’s a conundrum - a question of what might happen if you do and what if you don’t, take a DMD. You will never know whether you’ve made the right choice. All you can do is read up on the various drugs, think about the benefits versus the possible costs (reduction of number & severity of relapses versus side effects).
Have a look at https://www.mstrust.org.uk/about-ms/ms-treatments/ms-decisions-aid while considering.
The MS professionals generally believe everyone is better off with a DMD. I tend to agree, as do most of the other people who’ve answered your post. But, it is still your choice, and at the age of 26 it must be like choosing between side effects and ordinary life. You’ve certainly been lucky so far with relapse recovery. The big problem is that sometimes a relapse hits with an absolute wallop and recovery isn’t complete.
My DMD history is very mixed. I had my first MS relapse 23 years ago when I was 30. At that time there were no DMD’s available, so I first started a drug (Avonex) in 2002 - which was the year they first became generally available. Unfortunately, I had bad cognitive side effects so came off it, after a few months (once I figured out that it was the drug making me so stupid and managed to explain to my neurologist). I then started Copaxone. This worked well for about 5 years, with no side effects at all. Then I started relapsing again. It took quite a while to start another DMD for one reason or another, and in the meantime, I had a very nasty relapse in 2012.
This put me in hospital, then a rehab unit. I haven’t been able to walk properly ever since.
I started Tysabri, but after a few months it became clear that I had hepatitis as a side effect from the drug. Then I tried Tecfidera but had Lymphopenia (depleted lymphocytes - a type of white blood cell) from that.
It was decided that my MS had become progressive so didn’t worry about any other DMD’s. Until I had a clear relapse, then another, from which I had complete remission (even though by this time I was significantly disabled). So it was decided that I’d try Copaxone again. This time, I did get side effects - bad injection site reactions.
I called it quits. No more DMDs for me, regardless of what happens now.
So, you might think that after trying 4 different DMDs and having bad side effects from all of them (although Copaxone was fine the first time round), I’d be someone telling you to beware of DMDs. But I’m not, quite the reverse.
I have had very bad luck with my history of side effects, to have had such bad side effects from so many drugs is I believe unusual.
But, I am significantly disabled. Had I started a good drug (and there are some wonderful drugs available now), I might not be a full time wheelchair user. Being this disabled has caused me further problems that I might not have encountered were I more able bodied. For example, I had an accident (fell out of my 'chair) and broke my femur almost a year ago. Since then, I’ve had trouble even standing, let alone walking at all, regardless of aids. I also now have osteopenia (forerunner to osteoporosis) because of my immobility. So I could break further bones - I’m having to take a bone protective drug as a result.
I take lots of drugs to counter my physical problems. I had a colostomy 3 years ago due to bowel problems, caused by MS, and I use intermittent self catheterisation as I can’t wee on demand.
I believe that had I been able to take one of the newer drugs from the outset, and been fortunate enough to respond well and not have side effects, I wouldn’t have had the relapses that I have over my 23 years of living with the MS beast (almost 24 now!) I might not be this disabled. I might be able to walk, even if I needed a stick or a crutch. My bowel and bladder problems might be lessened. I might have fewer ongoing spasms and neuropathic pain so take less drugs.
My feeling is that you owe it to yourself to do all you can to reduce relapses and the severity of relapses. You’ve been lucky enough so far to have good remission, but that could change. My advice would be to consider seriously taking a DMD.
If however, you decide not to take a drug right now (and let’s face it, you can change your mind later!), the best advice I would offer is to get yourself as fit physically as you can. Get as strong a core as possible. Make your body your own defence against MS. Have your vitamins D and B tested by your GP and take supplements as advised by your neurologist. (Most recommend high dose vitamin D at the very least, and possibly B12 too.)
Eat well, try not to drink too much or smoke. Get enough sleep. If you get fatigued, rest properly. Consider taking a drug for fatigue if you begin suffering (Modafinil if you can get it prescribed, although that can be difficult, otherwise Amantadine). If you need to, use aids as recommended by an occupational therapist. See a physiotherapist and get an exercise plan worked out.
Keep in your mind that it is your decision, not your neurologist nor your MS nurses choice as to whether you should take a drug and which one, if you decide to take a DMD.
Best of luck.