PLMD starts whenever I get tired and sit down to relax, unless I ingest MSG, and then it starts within 7 minutes of the meal.

Over time, I have learned that I have specific dietary triggers: MSG, chocolate, and caffeine. Getting off these items has lessened the severity and I can manage the symptoms by taking the Nuepro patch.

It sounds like yours may also be triggered by diet. The problem is that MSG or a form of MSG is found in many processed food. Almost all fried chicken from fast food places has MSG. Of course, a lot of Chinese food contains MSG, and my experience in asking these restaurants if they use it usually results in bad information as they might not add MSG but they may use prepared sauces and soy sauces that contain MSG. Recently, I learned that the Whataburger hamburger contains MSG. Many Campbell's soup products contain MSG.