Dave,
If you are using XP Pro, some have found luck by removing and then reinstalling hotfix Q811493. If it is not on your system, you need to install, remove, install.
This helped my VPN out a lot....but it is not perfect. I find that my SME 5.6 at home will allow a fast stable connection out from a given client on the lan. Once I use vpn from another system.....things goto hell. A reboot resets it and if I use VPN from a single system on the lan things are great. When I mention another client using vpn, this is to the same SME server at work...so I don't know if it is the destination being the same or just another pptp client on a different lan ip address causing the problem.
I am also interested in the "mppe mdules patch" if this is something post U4. The first pptp patch worked great, but U4 supposedly applies this patch.
Good luck,
ryan