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Dear Dr. Roach: I just wanted to touch base with you about my diabetes. While my weight has stayed stable around 320 pounds, my sugar numbers have been increasingly hard to keep in line. I’ve maxed out on the oral medications we use. My latest A1c was 6.6. The doctor says it should be under 6 and that our next step is insulin. He asked me to try to lose 50 pounds over the next six months in order to get my sugar back under control.

I agree and want it to happen. I’m counting calories and cutting out carbs, and have started walking. I know I can’t run, with no discs in my bottom three ver­tebrae. But even walking is hard. I walk until my leg goes numb, but I don’t think it will be eno­ugh, and I may not even be able to keep that up. Even walking easy makes my hip hurt and leg go numb after about 20 minutes.

S.A.

Dear S.A.: I am surprised by your doctor’s advice, because it’s very clear now (from the ACCORD study) that an A1c (a measure of average sugar levels) of 7 percent has lower overall risks than an A1c of 6 percent for someone like you.

Exercise is always good, and my first thought is water. Getting in a pool will take pressure off your back, and you should be able to swim, walk in the water or do water-exercise classes to your heart’s content.

Dear Dr. Roach: I read a letter that seems to say the Department of Health and Human Services is against breastfeeding. There also was something about hospitals and insurance companies, but I’m not sure what that was all about. Up until now, I just thought that breastfeeding was the best I could do for my baby. But if that’s true, then why would the DHHS or hospitals be against breastfeeding?

S.G.

Dear S.G.: There is no doubt that breastfeeding is best for your baby. Breastfed babies have lower risk of becoming overweight and of many illnesses. The science is absolutely clear.

I read the letter I think you are referring to, and it seems to me that it is pointing out that some hospitals don’t do as good a job as they could in helping educate new mothers about why and how to breastfeed. According to the Centers for Disease Control and Prevention, without hospital support, one in three mothers stops breastfeeding. Only about 5 percent of babies are born in U.S. hospitals that are designated “baby-friendly.” I support initiatives that help promote breastfeeding in hospitals, and hope the DHHS gives its support as well.

Dear Dr. Roach: I have had allergies for the past 50 years. Every morning, my nose runs for approximately 15-30 minutes. I can’t take antihistamines due to heart issues. Any suggestions?

E.A.K.

Dear E.A.K.: Most people with heart and blood pressure issues who are warned about allergy medicines are warned about decongestants, not antihistamines. It may be safe for you to take an antihistamine, so you should ask your internist or cardiologist. I also have had good results using an antihistamine nasal spray such as levocabastine in people who can’t tol­erate antihistamines by mouth.

Email questions to ToYourGoodHealth@med.cornell.edu.

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