<s>[INST] I have copd asthma 3-4-5 vertebrates are in bad shape. I had surgery on my left knee but no luck with that but the doctor said he would not do knee replacement because he would not want to put me to sleep because of my breathing problems. I can not hardly walk and a lot of pain in my back also. Is there anything you could do to help me? [/INST] Thanks for your question on Chat Doctor. I advise you to first consult pulmonologist and diagnose yourself first. COPD and asthma are different entity and not the same. Treatment is also different. COPD is irreversible condition while asthma is fully reversible. COPD needs smoking cessation, pulmonary rehabilitation with chest physiotherapy and pulmonary vaccination with inhaled bronchodilator. Asthma needs identification of allergen, avoidance of it and anti-allergic Chat Doctor. So first diagnose yourself. And you can try physiotherapy for knee and back issues. </s>