Detached Retina Slows Work

On Sunday, November 2, the day of my last post, I called the UCSD Eye Center and drove down and was examined by the on-call ophthalmologist.  My symptoms were consistent with a detached retina, a condition classified as a medical emergency because it can quickly lead to blindness if not treated.   The peripheral vision in my left eye appeared to be reduced, as compared to my right eye, and there was a dark half-circle beginning to intrude into my field of vision.

The ophthalmologist saw what he thought was a detached retina, and advised that it would likely be treated that afternoon with a laser.  He was not certain, however, because he could not see any retinal tears, so he called in another senior resident who was specializing in the retina.

She arrived soon and, without asking about my symptoms, did what appeared to be a thorough exam of my retina.  Then she said I was fine, to go home and call the next day (Monday) to make a regular appointment for sometime during the next week, whenever they had an opening.

I was shocked, because I had researched the subject after earlier being warned about "dark curtain" symptoms by another doctor who had looked at my retinas a few days earlier, after I reported seeing flashes.  Flashes and floaters are symptoms of the eye's vitreous gel pulling away from the retina, a common occurrence that happens to almost everyone over 60, and also often precipitated by cataract surgery.  It's called posterior vitreous detachment (PVD).  When the vitreous gel that fills the eyeball starts to separate from the retina, it tugs on it, causing flashes.  Bits of the gel break off and are seen as "floaters," spots and shadowy forms moving across your field of view.  If the bond between the retina and vitreous is strong, the gel can pull the retina off the underlying tissue.  When this happens the vitreous liquid can seep behind the retina and peel it off like old wall paper.

I dutifully went home and continued my internet research into my symptoms and possible causes, and the next (Monday) morning called and made an appointment (for Thursday morning).  But during the day the small black half-circle continued to grow, and eventually threatened the center of my vision.  By this time, I knew that if a detached retina reached the eye's macula (the center area of the retina where light receptors are most highly concentrated), the chances are that treatment would likely not be able to restore vision to what it had been.  The longer the wait before treatment, the worse the prognosis.

So Tuesday morning I got up before dawn and made the rush-hour drive to downtown San Diego, arriving at the eye center before it opened.  I waited until they could fit me in; two hours later a triage ophthalmologist confirmed a retinal detachment.  She then ran off to find the eye surgeon.  She returned and said he would treat me, but he was also swamped with appointments and the wait would be two or three hours.

After another two hour wait, they put me in an exam room and dilated my eyes.  After another 30 minutes, the doctor arrived and did a thorough exam, mapping out all the small holes in my detached retina.  He said he would have to seal all of them; if he didn't, the vitreous fluid could get back in behind the retina and it would not reattach.  He then discussed the various procedures that were available.  I had researched all of them, so we quickly agreed on pneumatic, cryo-probe.  If treated the first time I presented myself (Sunday), a simple laser tacking of the retina would have worked well.  But now, with a large detachment and all the holes to repair, the cryo-probe was needed to freeze the holes, which would make the tissue "sticky" and seal the holes.

Furthermore, some gas would be injected into my eyeball.  The many bubbles would coalesce into a single big bubble over a few days.  The bubble of course would float to the top of my eyeball; I would be tasked with positioning my head so that the part of the retina that was detached would be above the bubble.  The bubble would hold the retina against the inside of the eye, forcing out the fluid and allowing the retina to reattach itself.  This procedure would likely work well, since my detachment was near the top of my eye.  I merely needed to hold my head upright and leaning to the left a little—for days and nights.

The doctor promised the surgery would start soon, and assistants began bringing equipment into the exam room.  There was another delay while the surgeon tried to catch up with his regular appointments, and then the procedure started (with local anesthetic, as I needed to assist by moving my eyeball to different positions). But then the cryo-probe would not get cold enough to freeze the tissue (applied to the outside of the eyeball, the freezing had to go all the way through to the retina).  Another delay while technicians replaced an empty gas cylinder, and the surgeon attended to his other patients.

The procedure took about fifteen minutes.  At first I could not see anything (my eyeball was full of tiny bubbles), but then cleared somewhat and I could see in the large portion of my field of view that had been black.  I drove home with my left eye closed, and ate dinner (first food all day), then propped up cushions on my sofa so I could sleep with my head upright (front to back), and tilted to the left about 20 to 30˚.

The next afternoon I returned to see the surgeon (who, by the way, was excellent).  He noted at one point that the resident had mis-diagnosed the retinal detachment (thinking it was just a vitreous detachment).  Everything was looking as it should.  He said to continue maintaining my position (night and day), and to return in two days (on Friday), when everything was still good (but "not yet out of the woods").  I no longer had to tilt my head to the left.

Then back five days later (Wednesday, the 12th).  He then said I could start sleeping on my back again.  I replied that I would prefer to continue sleeping with my head more of less upright, explaining that since the bubble was still there (it would take six to eight weeks to be absorbed), I thought we should keep it working holding my retina in place.  (This whole ordeal has been very stressful to me as I contemplated the prospect of losing vision in one eye.)  He then explained that he wanted to "test" the repair; if the retina pulled away again, he would tack the weakness with a laser.  That didn't appeal to me at all, given that the weekend was approaching.  The idea of again putting my eyesight into the hands of the on-call residents scared me.  The surgeon then negotiated for me to start sleeping in a normal position starting Sunday night (the 16th).  We'll see how that goes.

But back to the remodeling work.  It ground to a halt, and has since resumed at a relaxed pace.  I've completed the living room drywall work (joint compound, etc.), and painted the walls and ceiling.  I've started finishing off the drywall seams in the home theater, and laundry room, and put up another couple of sheets of drywall in the new laundry room.  I want to be able to seal that room off, either with permanent walls of plastic sheeting, so when I pull down the ceiling (opening up the room to the attic temperature extremes), the whole house will not be affected (so much).  I also need to take care of miscellaneous lighting/electrical/telephone circuits that have been languishing.

Most of this work is going slower because my left eye vision is still impaired.  It's okay when I'm looking straight ahead, but because the big bubble is still inside my eyeball, looking either up or down is a problem.  When I look down, the bubble moves up against the back of my eye, center of my retina.  I'm essentially looking through the  image of the bubble (with its dark border).  When I look up, the bubble floats up against the lens (behind pupil), and makes everything a blur.  When there is a bright light, the bubble causes internal flare and reflections.  I don't really mind it, because the bubble gave me my vision back, but it's there.

I'm still seeing some flashes, and still anxious, but hoping the fix holds and I won't need another procedure.  Too much work to do.  Stay tuned.

Putting up Drywall

Taking a break from the laundry room masonry.  Several other projects have been stalled due to a lack of drywall, but the orientation of the planets recently came into alignment and a truck arrived from Home Depot loaded with "things that would not fit in my car."  To wit:

Up first was the opening between the new laundry room and the home theater.  I had some time ago filled in the space with studs, and then covered that with plastic sheet to keep the clouds of concrete dust out of the home theater (or at least to limit it—the dust goes all over the house).  I couldn't drywall over the studs without first running electrical cables through that wall from the new sub-panel, but running those wires meant I would not be able to get through the stud wall to enter my only bathroom.  That meant taking down the old bathroom wall and putting in a new pocket door for access from the home theater/guest bedroom into the guest bathroom.  Cascading projects.

This next photo shows the restructured wall for the installed pocket door kit (taken from inside the bathroom, looking through the door into the home theater).

Once the wiring was in place inside the wall (laundry room receptacles, plus one facing the home theater, and including a dedicated receptacle circuit for the future heat pump air handler), the drywall went up on the laundry room side.

And a shot from inside the home theater of the other side of the new wall section, plus the new pocket door.

The new drywall still needs to be finished off with joint compound and paint.  The other area that had been waiting for drywall was the south-facing living room wall.  I recently installed a new window there, but I also planned to add an inch of rigid foam insulation over the old drywall, and then put up another layer of drywall.  The extra insulation and mass not only keeps out the heat (and cold), but also attenuates the noise from the busy road behind my back yard.

I added sleepers fastened into the underlying studs, then added the rigid foam insulation, then the new drywall.  After that, the window was trimmed out (with a nice wide sill for the cats).

Lots of joint compound, spackle, caulk, and paint to go, so that's what I'll be doing next.  Complications from my second cataract surgery means no heavy lifting again for awhile, so laundry room masonry and restructuring will have to wait.

New Laundry/mechanicals Room - Part 5

Even slower going than I expected.  But in the end, progress.

The 2" ABS drain pipe descending into the concrete was of course the challenge.  But down I went, deeper and deeper.  Deep enough to finally start gluing together the horizontal drain pipes feeding from the two floor drains and the washing machine drain.  I needed to start assembling the system in order to measure how much deeper I needed to go down, and that turned out to be 3"—into solid concrete.

Another jack-hammer session and I was there.  I could saw off the pipe and glue on the first connecting "tee" fitting.

But first, I needed to remove the duct tape the original builders had wrapped around the pipe.  As I did that, I discovered an elbow fitting; my nice vertical pipe had made a right angle turn to horizontal!  I would not be able to attach my tee.  If the vertical pipe had only gone down another 1.5", I would be done.  No such luck.

I took a break and developed Plan B.  I would have to go down yet further into the concrete and tie into the horizontal drain, but first I needed to see what was down there, so more work for my demolition hammer.  I discovered the elbow was of the "long-turn" variety; it had a larger radius than a standard elbow.  If I replaced it with a standard elbow, I could gain a little more than an inch of the 1.5 that I needed.

And when I looked at my little collection of ABS drain pipe fittings, I noticed that I could gain another half-inch if I used "street" elbows (which have one male and one female end) instead of the standard elbows (with two female ends).  Hooray!  I could get my 1.5"!

All I had to do was blast out enough more concrete to be able to saw off the old long-turn elbow.  I also needed enough clearance to clean off the end of the horizontal pipe, so I could get a good glue joint to the new, smaller elbow.  That was not going to be easy, though, as the pipe was angling into the concrete side of the narrow deep trench, and I was using a big heavy demolition hammer to surgically blast away the concrete.  As I noted to my brother in an email, if I punctured the pipe, I would be screwed!

So of course I couldn't see what I was doing, and an electric jack hammer is no scalpel, so when I cleared away the debris, there was the hole.

The view didn't look like that when I did it.  The above photo was taken after I enlarged the 6" wide trench into a huge cavern.  By this time my excavation was 20" deep (did I mention through solid concrete?).

But there it was.  After cutting off the pipe behind the puncture, I started measuring and gluing the pieces of black plastic together, first connecting one side of the drain system, and then the other.

After that, it was the usual filling the hole with sand, some of the clay I took out, and a little of the concrete rubble.  This was done in layers, tamping the sand down and making sure the horizontal pipes had the proper slope, and the floor drains were fitted so they would be just slightly below the level of the finished floor.  Then it was time for concrete.  I ran out (typical) and had to buy another couple of bags to finish,  but it was finally done.

Well, not done done, of course.  Part of the floor still has old tile on it, and the underlying mortar.  And half of the floor (the original small garage-based laundry room) is about a half-inch lower than the house-based half, so that needs floor leveler.  And then tile.  And electrical, drywall, new ceiling, water supply lines, etc.  Sigh.

Slow Going

Well, there has been some progress—good progress, really—just not fast progress.  Trenching in concrete is not something that flies.  But this is where I am:

That stud compartment in the back (the black segment, without the yellow insulation, is where the drain pipe for the washing machine will go.  The 2" ABS drain pipe will go down through the bottom of the wall and run along the trench, and then empty into the vertical pipe (in the middle of the trench, where it makes the turn).  Unfortunately, that vertical drain pipe is located in the foundation wall, meaning it's encased in concrete half-way to China (or at least as far down as I need to go).  It has to be cut off maybe 18" below the floor level in order to make the necessary connections.  Slow going.

Partway down that far trench, I have to put in a floor drain that will empty into the washing machine drain; the floor drain is for the condensate from the high-efficiency water heater (the one I haven't bought yet).  At the near end of the trench (not quite finished), there will be another floor drain; this one for the air-handler condensate drain, as well as the water softener back-flush drain.  All of this will be clearer as we proceed (in a month or six).

Much of the slowness has been due to the fact that the back (long) part of the trench had to be blasted out of what had once been the garage floor.  The garage floor was, of course, a concrete slab, maybe 4" thick.  When a prior owner decided to convert the back half of the garage into a bedroom, they had to raise the floor level another 4" or so to match the floor level in the rest of the house.  Meaning—they poured another concrete slab on top of the garage slab.  So I had to trench down through two slabs, one on top of the other.  As I said, slow going.

Unpleasant work, but I've been approaching it as if it was a hobby, a few hours a day.  Cut the boundaries with the diamond bladed circular saw—huge amounts of cement dust.  Blast away at the concrete with my beloved (but heavy) electric demolition hammer—also lots of dust.  Then down on my knees in the room full of dust to dig out the debris and haul it outside by the bucketful.  Knee pads, ear plugs, gloves, full-face respirator, and a hood.

The full-face respirator is incredible!  Highly recommended.  Keeps all the bad stuff out of eyes and lungs, and the faceplate doesn't fog up, even when the sweat is pouring down my face (yes, breaking concrete is good cardio).

Can't keep that up all day—my knees won't take the bending, so I've filled in my breaks with other new hobbies, to wit, designing and building violins.  Well, yes, odd, since I don't play the violin.  In fact, I've never even seen one in person, but I like to learn completely new things.  Interesting community, violin builders are (ain't the internet wonderful!).  The remodeling continues to take up too much space to build violins yet (what with the gutted rooms piled with junk—er, valued possessions—waiting to find their places in the finished house), so I've just been designing.

Perhaps violins are not so strange, because I did actually build high-end electric guitars for some years (and I never played those either).

No room to build a violin (yet), but I did just finish building a violin bow yesterday.  That was, how shall we say, a learning experience.  Not sure what I'm going to do with it just yet.

That nice black thing in the bottom photo (called a "frog," with the abalone dot with the circle around it), was store-bought—that I didn't make.  The "stick"—the long part that looks like a stick, is made from cocobolo.  Every other violin bow in the world (pretty much) is a plain straight stick all the way to the back end.  My bow has a "pinky perch" at the back end, over the frog.  Self-respecting violinists, who have been practicing for hours a day for years, have developed pinkies with the strength, dexterity, and coordination to stay on a plain stick without assistance.  When I tried it, no such luck (and I've read that other newbies have the same problem, so the pinky perch is my contribution to violin bow ergonomics).  I expect it will remain a one-of-a kind.  Hmm.

Okay, in the evening I always try to spend some time working on Daughtry's World, my current novel-in-progress and the fourth in the Samsara science-fiction series.  I pretty much have the complete chronological narrative figured out, and the character arcs as well.  I have started putting together the scene outline—in other words, the structure of the novel from beginning to end.  Since this is a murder mystery, the book will most certainly not start at the chronological beginning of the events that led to the three linked murders.  The first scene is to be the assassination of the third victim, during which two of the three assassins end up dead (the victim definitely fought back!)

In the next scene, Kevin Daughtry (the investigator, and past Samsara character), is pulled from his regular posting to investigate the murders.  He doesn't know why they picked him, and his contact (another past Samsara character) won't tell him much.  And it goes from there, with flashbacks filling in the story as Daughtry solves the riddles of the mystery, with a little help from his friends.  It's been slow going for me, but the process should now go faster.

The story will have its own arc, but it will also fill in further pieces of the greater arc of the whole Samsara series (and that world).  My intent is to ensure that Daughtry's World can be read by itself, but obviously people who have read the first three novels in the series will get more out of it.  I try to put a lot of depth in my stories (I want every word to have significance); if a reader skims, he or she will miss much of the experience.  Many may find that a second reading is even more gratifying than the first, especially after taking in one or more of the other novels in the series.

Next time, the laundry room drain pipes go in.

New Laundry/Mechanicals Room - Part 4

I had my second cataract surgery a week ago, so another week before I'm cleared to start doing heavy demolition (i.e. trenching through concrete).  I'm in no hurry.  I did manage to get some of that work done before the latest surgery, to wit, running a new drain line from the future location of the guest bathroom vanity sink, to an  existing vertical drain pipe (that had been used for the old master bathroom vanity).  Confused?

Before I did that, in an effort to contain the thick clouds of concrete dust produced by the diamond bladed circular saw slicing through concrete, I built the wall that closes off the opening between the home theater and the new laundry room.  Photos taken 1) from the home theater, and 2) from inside the laundry room.

Then I put plastic sheet over this new stud wall and started cutting through the concrete.  The slab was only about 3" thick where the new drain pipe needed to go, but it quickly got thicker, more than a foot thick, as I worked my way toward the foundation wall of the house proper.  I discovered that beyond that (what was originally the garage), there was no foundation wall under that slab edge, and the slab was only about 4" thick.  Good news for when I get around to trenching for the new washing machine drain line.

Once that new trench was filled with concrete, I could build the part of the laundry room wall that separates it from the new guest bathroom.  The new wall is flush with the back wall of the laundry room, and provides more area for the guest bathroom, needed for a new vanity (and some storage).  That new wall segment will also house a new electrical subpanel, replacing the old, physically smaller subpanel box that was in the old, smaller laundry room (it's about five feet to the left of where the new panel is).  You can see the new panel in this photo, just sitting in place for the photo.  The old smaller panel, besides being cramped, is located behind where the washer and dryer will be going, which is a no-no.  The area in front of electrical panels has to be open.

You might also notice that the door leading to my only current bathroom is now behind a stud wall.  That door, and the whole wall it is in, will be removed (soon), and a new pocket door will be installed between that bathroom and the home theater (which will also serve as the guest bedroom).  Until that happens, access to the bathroom will entail sidling between the studs.  Good thing I'm thin!

My New Oven is Operational!

After more than a year without a real oven, my wait is over.  After making the electrical connections, I put my new oven to the test.  No more store-bought bread, no more frozen pizza!

I'm now recovering from cataract surgery on my right eye, and expect to have the same procedure done on my left eye within a few weeks (all that time out on the water in the bright sun).  No heavy lifting allowed, so breaking through concrete to run new drain pipes will have to wait a little while longer.

The New Kitchen - Part Three

My brother just came for his short visit today; I had three lifting tasks ready for him: 1) getting a new heavy jointer (big power tool) out of the back of my car, 2) lifting the new large and heavy living room window into the opening I had prepared just for this occasion, and 3) helping to lift my oven into the new kitchen cabinets I just built.  The making of the kitchen cabinets had moved to the top of the priority list after I learned he was coming (three weeks notice).

I had been doing conceptual design work for quite some time, but I still needed to decide on some specific dimensions and put them to paper.  I prefer to build cabinet bases separately, make them all nice and level, so that after that it is just a matter of plopping the cabinet cases on top of the base.  I am making the bases out of 2 x 8s, which makes the bases nominally 7.5" tall, but during leveling on the un-level concrete floor, I removed up to a half-inch of that height.

Stock bases are typically recessed 3" from the cabinet faces, and so are mine.  While my bases are about 7" high, stock kitchen cabinets generally have a much lower toe-kick (about 3"), but I've found that my toes tend to kick the bottom edge of stock cabinets, so I wanted more height for my big feet.  Stock cabinet bases are also made from 3/4" stock, but I wanted mine to be sturdier.  The base was secured to the studs in the wall, and also screwed down to the concrete floor.  Overkill?  Maybe, but we have earthquakes out here.

I was making two cabinets — one for the wall oven and the other adjacent one would house the microwave.  Also lots of drawers beneath the ovens, and above the ovens, slide-out shelves (like sideways drawers).  These are big cabinets, 28" deep, and tall.  I put the car out of the garage to make space for cutting out the pieces and assembly.  The cases are made from 3/4" cabinet-grade plywood, with 1/2" plywood backs.  All the pieces are glued together with tongue and groove joints, biscuits, and plywood lugs supporting structural shelves.

White plastic laminate was put on the side that will show; the plastic laminate also went on the microwave oven shelf.  When the cases were finished, I placed them on the base and lined everything up, then screwed them together, to the base, and to the studs in the wall and to the overhead soffit.  Not going anywhere.

With the cases securely in place, I applied 3/4" solid maple facing to the plywood edges, and applied three coats of satin polyurethane to the maple.  I finished connecting the electrical receptacle in the microwave cubby, and drilled a hole for the cable from the oven to the compartment above, where the junction box will go (connects to the cable from the breaker box — 30 amp, 240 volt circuit).

I still have to build all the drawers for the two cabinets (and lots more cabinets for the rest of the kitchen), but once I make the electrical connections, I will finally be able to bake again!