<s>[INST] I am on disablilty through social development in BC, I have had numerous operations on my knees due to sports and physical injuries, 2 years ago I slipped, hurting my right knee which has had acl damage with hamstring replacement, I first say Dr O Farrell, who recommended arthroscopic surgery for cartilage removal, when I didn t hear from him or the Kelowna General surgical booking department, I called back to find he had retired, I was then given Dr. Curtis Myden as a surgeon, of the Kelowna Orthopedic Office, who I finally got to see today after sitting in his office for 2 1/2 hours, was told that the grinding noise was arthritis, fair enough, and that I walk poorly because of pain, absolutely brilliant deduction that is, and if I had money to pay for treatment or therapy he would refer for that, but since I don t, he guesses I should have another x-ray of my knee, which one would think he possibly could of thought of during the interim between referral and seeing him, I have asked my physician to refer me to another ortho, not in that office, as I don t believe we have a two tier medical system yet, where the wealthy get better treatment than the poor, it is also difficult for me as I live 80 kilometers away from Kelowna, due I have a valid complaint, which from what I read on the college of physicians and surgeons for Dr Myden providing inadequate care and/or treatment of my knee. I had difficulty getting the Ministry to provide funding for the transportation, and if I had missed this appointment, Dr. Myden would have billed me 100 dollars for missing it, to have absolutely nothing done about my knee except to be told that I walk poorly because of pain, and that if I could afford it, he would recommend therapy for the muscle wasting in my knee, and to get another x-ray, as the previous one is two years old. Do we have a two tiered system where doctors can bill people for missing appointments due to weather and transportation costs, and to not try to seek alternative arrangements for care, of a person, regardless of income level, or even in spite of it here in BC that I know nothing about? [/INST] Hi,First thank you for providing the brief history of you. I am sorry to hear about all these trouble getting towards you. Let me focus on what I can guide you which can help you fight the trouble you are facing physically. You mentioned you have pain in the knee joint due to arthritis.Let's look into the deep of it. You had ACL and Hamstring issue. Now arthritis is an aging process for which no one can reverse it except your own body. Human body is a self healer and what medicine can provide is to support the systems which can help it to heal and allow physical status of the body. Since you had ACL and hamstring repair, Your need to focus on One simple thing now, that is strengthening the body as a whole unit. For which you may need some proper guidance, assistance and support. You need to start slowly first doing the ankle toe movements, which will help to get the strength in the muscles of the leg and also the vascular system of the below knee will improve.Don't get bore here. There is still more to focus here. Look for lying down on your back and do straight leg raise and hold for as long as you can as it will be isometrics and isometrics give abundant strength in the muscles. Next you need to do not only for the leg affected but also the leg which is not affected as well. Since body works as a unit and the unit has to be gathered with each way. Same leg lifting you can do by lying down on your side and lift it up sideways which will strengthen the side of the thigh muscles. Then proceed onto strengthen the back of the thigh and the inner of the thigh. All the exercises you can either learn from a physical therapist of either you can learn from research articles available on Google. As in the research articles they mention the complete detail of the same without anything missing. Strengthen your core muscles and also strengthen your spinal muscles as well. Do try to achieve plank exercises for 3 minutes for a minimum and go up to 10 minutes. Perform reverse walking and see to that you strength the last 1/3 of the qua Chat Doctor. Strengthening the lower body as a whole on both sides will help you a lot by fighting the arthritis issue. Try to perform knee ROM exercises as it is a must to have a complete ROM in each joint. Do single leg standing and sitting up exercises which will give you immense strength as well. This is just the beginning. Once you master in this will teach next. I have seen many cases with OA knee and my all cases are above 60. All does well and do on a regular basis running without any pain and aches. With the grace of god I wish you a good healthcare you need more information you can contact me. RegardsJay In </s>