Dear Doctor: My 80-year-old mother has been diagnosed with congestive heart failure. What is it, and is there anything she can do to keep it from getting worse?

Dear Reader: In congestive heart failure, the heart is no longer able to pump blood efficiently. This can be because of narrowing of the arteries that serve the heart, diabetes, high blood pressure, heart valve disease, congenital defects or damage to the heart muscle from a heart attack.

Although heart failure can't be cured, it can be managed with medication and lifestyle changes. To begin with, basic healthy-living guidelines are more important than ever. Maintain a healthy weight, get daily exercise and keep blood pressure under control.

In addition:

-- Be vigilant about medication: Your mother's cardiologist will have prescribed one or more drugs to manage the effects of her declining heart function. These may include a diuretic to deal with excess fluid, a beta-blocker to manage arrhythmias, an anticoagulant, statins to control cholesterol and medication to control heart rate.

-- Know your meds: You and your mother should learn the purpose of each drug that she takes. It's a good idea to post a detailed list of her daily drug regimen in a visible spot. Write down the name of each drug, the amount she must take and the time of each dose. Be sure to include potential side effects for each medication so if something goes wrong, that information is easily available.

-- Eat a heart-friendly diet: Get your mom to skip the processed foods. Instead, go for fresh fruit and vegetables, whole grains, beans and legumes. Protein should come from lean meats and fatty fish like salmon, which is loaded with omega-3 fatty acids. Stick to healthy fats like olive oil. Limit or quit caffeine, and steer clear of sugar and sugary drinks.

-- Be aware of salt: Sodium makes you retain fluid, so limiting salt is important for your mom. Most of the salt in our diets comes not from the shaker on the table, but from processed foods. Read labels and limit sodium to 2,000 milligrams per day.

-- Watch the fluids: We're talking about an important balancing act here. We need to take in enough fluids to stay hydrated, but for people with heart failure, too much can make it harder for the heart to pump. Your mother's cardiologist will have given her a target amount, likely in the range of 48 to 64 ounces per day. It's important that she stick to it. And don't forget that juice and soup count as liquids.

-- Get on the scale every day: A sudden weight gain of 2 pounds or more can indicate a serious problem. If that should happen, your mother should call her doctor immediately.

-- Look for other warning signs: dizziness, fainting, sudden shortness of breath, heart palpitations, increasing exhaustion, and abrupt swelling in the feet, legs or ankles. Any of these should be reported to her doctor right away. Even a change in her physical abilities -- a walk that had been easy and has now become laborious -- can indicate problems.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Could acupuncture help my carpal tunnel syndrome?

Dear Reader: Carpal tunnel syndrome (CTS) is caused by compression of the median nerve within the wrist, specifically in an area called the carpal tunnel. The symptoms include pain or numbness that radiates to the first three fingers of the hand. The sensations can awaken patients at night or strike when they're doing certain activities. When the median nerve is significantly compressed, a person can develop weakness in the thumb and fingers and have difficulty even holding a cup. Wrist splints, physical therapy, NSAIDs and steroids can initially address the condition, while surgery is often recommended for severe cases. But only recently has acupuncture been studied for carpal tunnel syndrome.

Let's start with a 2011 review of multiple studies of acupuncture for carpal tunnel syndrome. Many studies were not randomized controlled trials, but the authors were able to evaluate six trials: four done in China, one from the United States and one from Germany. Five of the studies used needle acupuncture, and one of the studies used laser acupuncture, which targets acupuncture points with low-energy laser beams.

The U.S. study compared acupuncture in traditional acupuncture points with acupuncture in random points, called sham acupuncture. That study found no difference between the two types of acupuncture. Two studies that compared steroid injections to acupuncture found a greater benefit with the use of acupuncture. A study comparing massage to acupuncture with massage found greater benefit with the acupuncture version than with the massage alone. And a fifth study, comparing acupuncture to oral steroids, found only a mild benefit from acupuncture. As for the laser acupuncture trial, it found a greater benefit with laser upon traditional acupuncture points versus laser upon sham acupuncture points.

Overall, those authors concluded that the data supporting acupuncture for carpal tunnel syndrome are encouraging, but not convincing.

A 2012 study performed in Iran was slightly more positive. It compared the use of wrist splints at night along with two acupuncture treatments per week for four weeks versus the use of night splints along with B12 vitamins and sham acupuncture. Symptom scores stayed unchanged in the sham acupuncture group, but significantly improved with the use of traditional acupuncture points. In addition, nerve function slightly improved with the use of traditional acupuncture points, but not with sham acupuncture.

A 2017 U.S. study divided 79 carpal tunnel patients into three treatment groups: one group that received acupuncture with electrical stimulation against traditional points near the wrists; another group that used sham acupuncture; and a last group that used acupuncture with electrical stimulation against traditional points, but in an area far from the wrists. Each group had 16 treatments over eight weeks.

The authors found a greater improvement of symptoms with the use of traditional wrist acupuncture and electrical stimulation versus those who had sham acupuncture. They also found improvements in nerve conduction using the acupuncture with electrical stimulation against both local and distant points. What was most interesting about this study was that the authors showed how acupuncture in traditional, and not sham, acupuncture points caused brain changes on functional MRIs, which correlated with a decrease in symptoms of CTS.

If you have mild to moderate carpal tunnel syndrome, it certainly seems worth considering acupuncture in addition to wrist splints at night and physical therapy. However, more studies are needed to solidify this recommendation.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Can you settle an argument in our family? Ever since the Ebola virus hit the news, my aunt has been using antibacterial products for everything. She even had the kitchen walls coated with antibacterial paint! But from what we're learning in biology, that's not going to help against a virus. Who's right?

Dear Reader: It's true that whenever reports of a dangerous outbreak like Ebola, bird flu or the Zika virus hit the news cycle, sales of antibacterial products spike. People are understandably concerned about their health and safety, and are responding to news reports that can be high in drama but low on important details.

What you're learning in biology is correct. Antibacterial products will have no effect on a virus. In fact, there is growing concern that the overuse of antibacterial soaps, lotions, laundry products, cosmetics and even house paint may cause more problems than it is solving. A bit about that in a moment.

But first, what's the difference between a bacterium and a virus?

A virus, which needs a host to survive, is basically a Trojan horse. It's made up of a protein coat that shields a core of genetic material. Once inside the body, the virus enters a cell and hijacks its biological mechanisms. It forces the cell to turn out thousands of new copies of the virus, which causes the cell to die. These newly minted viruses then go on to attack fresh cells.

Although they cause a host of deadly illnesses, viruses are not all bad. Thanks to their vast numbers and remarkable diversity, scientists believe that viruses have beneficial functions that are not yet understood. In fact, some leading-edge research into cancer is exploring how to harness the unique properties of viruses to formulate new medications, as well as find mechanisms to attack disease cells.

Bacteria, by contrast, are tiny one-celled organisms that can reproduce on their own. The vast majority of them are benign and even helpful, as we're learning in our research into the gut biome. Less than 1 percent of bacteria cause illness in humans. Those that do emit toxins that damage tissue, interfere with important biological pathways and make you sick. Illnesses caused by bacteria include food poisoning, Lyme disease, pneumonia, cholera and dysentery, to name just a few.

Like viruses, bacteria reproduce quickly. Unlike viruses, they can proliferate outside of human cells. That means that good hygiene is the best defense against the spread of bacterial infections.

So how can products that target bacteria be bad?

The problem is that antibacterial products aren't 100 percent effective. The bacteria they leave behind can, over time, develop a tolerance to certain antibacterial agents in the products, a trait known as cross-resistance. Scientists are concerned that this can lead to genetic mutations that will make bacteria immune to antibiotics.

But we have good news.

According to the FDA, plain old soap and water is still the best defense against bacterial contamination. Soap lifts dirt from your hands and, with 30 seconds of scrubbing and a thorough rinse, the bacteria are down the drain.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)