So at some point about a month and a half ago, my frame rate when from nothing to worry about with all graphics on their max settings to nearly unplayable with a config file to boost my frame rate.
This about the time they added the second misc slot. I'm currently doing a full unistall/reinstall, but I'm looking for any other issues that might help.
For reference, here are my computer specs:
Intel Q6700 @ 2.66 GHz
4 GB ram
NVIDIA GeForce 8600 GT w/256 MB (currently updating the driver)