May 2008


After opening up the walls in the kitchen, I discovered several examples of poor workmanship that date to the original construction of the home. There also exist cases of poor workmanship as a result of work done by previous homeowners. But most of those are cosmetic or easy to fix, so I won’t dwell on them. The problems I want to focus on are either structural or expensive to fix.

In the first example (see photo below), there is a header over the doorway between the kitchen and the former dining room. It is framed with what was originally a 2×12, however there is a 2-inch deep notch cut into the bottom (who knows why) and just above the notch there is a 2-inch knot that has checked (cracked), leaving this header with the strength of a 2×8.

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This header is notched and has a big knot. Photo by George Taniwaki

The second example (see photo below) is also an incorrectly framed header. This header also started as a 2×12. However, notice that it has split, leaving it with only the strength of a 2×6.

The reason the header split is that the framer used too many nails to attach the header to the king studs. There are four nails spread evenly on each side of the header. Everything fit fine when the framing was new. But as the wood got older, it dried out and shrank in the direction opposite of the grain. The grain in the header and the studs are at right angles, the shrinking header gets narrower, but the king stud doesn’t get shorter. The stress caused by the nails eventually forced the header to split. But worse than that, notice that because the header has shrunk, it is no longer resting on the jack studs. (You can see a gap between the header and the jack stud.) This means the entire load is being carried by the double top plate and by the nails that hold the header in the king stud. Luckily, this header only spans 24 inches, so it was way oversized to begin with.

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This header is cracked and is not resting on the jack studs. Photo by George Taniwaki

I own a lot of tools. And I mean a lot. But I am now faced with a project that I can’t complete because I don’t own the right tool.

In creating a new office for Sue, I have demolished a coat closet and now want to remove the sill plate (or sole plate) for the former wall in order to make a doorway to the office. But I don’t want to damage the existing floor on either side of the sill plate and don’t want to remove the entire wall. What I want to do is cut the sill plate flush to the existing stud.

I can’t figure out an easy way to do it. A standard flush cutting saw (of which I own several) won’t fit because on either side of the sole plate the floor has been raised to a finished surface. On one side is a Pergo laminate floor, on the other is ceramic tile, see photo below. I could use a chisel to cut out the sole plate, but that would take a long time, and there is a chance I could hit a nail and ding my chisel point.

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How can I remove this sill plate? Photo by George Taniwaki

I’ve seen infomercials for a tool called the Fein Multimaster that can do the job. The Multimaster is a hand-held oscillating tool that looks like a detail sander. However, it has more power and can take a variety of attachments. You can watch the video on YouTube. But it is really expensive. It’s available at Amazon for $389.00. (By comparison, my Ryobi detail sander cost about $35.)

The Multimaster will also be handy for removing the tile from the floor and for cutting out pieces of the of Pergo flooring around the new door. I’ll have to think about it before plunking down cash for yet another tool though.

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[Update1: I bought the Fein Multimaster and I use it all the time. It’s great. However, the tool is expensive at almost $400 and the replacement blades are too at $20 each. The patent just ran out in early 2009, so I expect clones to be available soon from competitors like Ryobi, Ridgid, Craftsman, etc. I haven’t seen them yet, but once they do, prices should drop.]

[Update2: I just saw an infomercial for the Rockwell Sonicrafter, available at amazon.com. It’s only $179.00, but the tool is heavier, doesn’t have variable speed control (which makes it hard to handle), and doesn’t have a quick release blade attachment (which makes it hard to switch back and forth between cutting and scraping). Bosch has a their own oscillating tool called the Multi-X, but is only available as a 12V cordless tool. It’s also available at amazon.com. Dremel (which is owned by Bosch) makes a less expensive oscillating tool called the Multi-Max, available at amazon.com for only $90.]

by George Taniwaki

Sue and I have been in the planning stage of remodeling the first floor of our house for the past 3 years. Now we’ve finally started work. We are acting as our own general contractor, coordinating the trades, and will be doing a lot of the grunt work ourselves. This post contains a floor plan for the remodeling project along with some “before” pictures. Our architect is H. Robert Soderstrom of Soderstrom Architects in Boulder, Colorado.

Our house was built in 1980 and has a typical floor plan for that era with the space divided into small disconnected rooms. The kitchen is designed as a workplace and not as the entertainment/gathering place.

Our redesign opens up the floor plan by removing two walls to create a single space that contains the kitchen, dining room, and living room. The kitchen will be larger with lots of counter space. We are also creating an office for Sue.

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Figure 1. The new floor plan overlaid on the existing plan. Drawing courtesy of Soderstrom Architects

Foyer

Currently, the first thing a visitor sees when entering the house is the side of the refrigerator (Fig 2, in the background). We will be moving the refrigerator and placing a more visually pleasing focal point in its place, a breakfast counter with a soapstone counter and topped with a fused glass bar area.

ExteriorBeforeLooking7W

Figure 2. The front entrance looking west into the foyer. Notice the door swings to the right

Once in the foyer, one would normally turn right (north) to the stairs or to the living room (Fig 3). However, to do that, one has to close the front door first because it swings the wrong direction. We will be switching that during the remodel. Turning left from the foyer (south) leads you currently to a coat closet and the dining room (Fig 4). We will be removing the coat closet to open up the space and I will build a mission-style coat tree with lift-up seat (I’m a woodworker). We will add a wall with French door to the old dining room, turning it into an office.

EntryBeforeLooking1NEntryBeforeLooking5S

Figures 3 and 4. Inside the foyer looking north into the living room (left) and looking south into what (was dining room) will be Sue’s new office (right)

Living room

The living room is in the northeast corner of the house. It is a bit small and unused because it is closed off from the rest of the house. A load bearing wall will be removed and the adjoining room (formerly a family room) will become the new dining room (Fig 5).

LivingBeforeLooking7W

Figure 5. The living room looking west; the load bearing wall in back will be removed

Kitchen and dining room

In the southwest corner of the house was a kitchen and breakfast nook. Next to it in the northwest corner was a family room. We are demolishing the wall between these two rooms, moving all the plumbing, gas, and heating to create an open plan kitchen/dining room combination. The doorway (on east) between the kitchen and the old dining room (Sue’s new office) will be closed off (Fig 6). The load bearing wall will be replaced with a beam to allow us to fit custom cabinets, a walk-in pantry, and a 36-inch refrigerator in this space (Fig 7).

KitchenBeforeLooking3aEKitchenBeforeLooking3bE

Figures 6 and 7. The kitchen looking east; the doorway on the left will be closed off and the load bearing wall will be removed

For more ideas on home remodeling projects see the Home Remodeling Guide.

All photos by George Taniwaki except as noted

[Note: This entry was actually written in Sep 2009. I changed the posting date to keep my blog entries in chronological order.]

The National Kidney Registry has sent me a swab kit. I need to rub the swab inside my cheek, let it air-dry, put it in a test tube, seal the tube with a stopper, and mail the tube to a test lab.

I assume the purpose of the swab is to get a DNA sample to run a genetic test called the human leukocyte antigen (HLA) typing test.

The immune system contains antibodies that have a wide variety of tips. Each tip will adhere to a different surface molecule called an antigen. When an antibody adheres to an antigen, it reproduces (the new copies will find additional instances of the antigen) and causes the body’s leucocytes (white blood cells) to attack and reproduce (so they will destroy the substance containing the antigen). Normally, the substances that are attacked are microbes that can cause disease.

Human cells are also covered with antigens that would cause an immune response. Through some magical process, the immune system destroys any antibodies that would adhere to the self-antigens before they get into the blood stream. (If the destruction process isn’t complete, then the self-targeting antibodies circulate in the body and eventually adhere to normal cells. This causes leukocytes to attack the cells. This leads to autoimmune diseases like asthma, lupus, or rheumatoid arthritis.)

If chosen at random, the cells in a donor organ (or transfused red blood cells) are unlikely to coated with the same self-antigens as cells in the recipient. When transplanted, the foreign cells will trigger an immune response. If this immune response is not prevented, the recipient will become very sick as the immune system attacks the transplanted cells. The transplanted cells will be killed and the organ will eventually fail. This is called organ rejection.

Part of the effort to reduce the chance of rejection is to choose a donor whose cells are coated with HLAs that the recipient does not carry antibodies for. The most virulent immune response comes from a set of antigens known as blood type. (More on blood type antigens in a later post.) For most transplant recipients, this is the only antigen match required for a successful outcome.

However, just matching blood type antigens isn’t enough sometimes. Some patients who need a transplant start have come in contact with foreign HLAs and start producing antibodies to them. This contact is often due to having received repeated blood  transfusions (often from receiving human-derived EPO during the course of dialysis therapy) or having a previous organ transplant. Women may also develop antibodies for HLAs after becoming pregnant multiple times from the same father. These patients have antibodies that will adhere to the surface of transplanted cells. This will trigger an immune response that leads to organ rejection. In these cases, the recipients will require donors whose cells have surface molecules do not include any of those HLAs.

Matching blood type antigens is fairly easy. There are only two genes involved with a total of eight possible combinations. However, there are many HLA genes, of which three pairs are most influential in organ rejection. Every person receives half of each pair from each parent for a total of six combinations. Each gene may have hundreds of known alleles, meaning there are millions of possible combinations and it is highly unlikely that two unrelated people will match all six by chance. Patients who have become sensitized to non-self HLAs must have a donor who does not have the HLA for which they have antibodies for in order to avoid organ rejection. They will have a much harder time finding a suitable donor. Even if the recipient is not sensitized, getting an organ that is a so-called 6-HLA match can lead to better outcomes.

In all cases, unless the donor and the recipient have identical antigen profiles (probably only occurs when the pair are identical twins), there will be an immune response unless some additional action is taken. Thus, after receiving a transplant, organ recipients will need to suppress their immune system through the use of anti-rejection medication. They will need to take these drugs for the rest of their lives. (More on the the Medicare limit on reimbursement for the cost of these drugs in a later post.) Because the immune system is suppressed, some patients also take anti-infective and anti-ulcer drugs to protect them from opportunistic infections.

For all the risks to the recipient, a kidney transplant is a much better long-term option for most patients than dialysis. (More on dialysis in a later post.)

[Note: This entry was actually written in Sep 2009. I changed the posting date to keep my blog entries in chronological order.]

Today, I receive two separate emails from the National Kidney Registry stating that they never received my physical exam report or lab test results. I call them and it turns out that they did and the emails were sent in error. However, they do need a printed confirmation of my blood type. It’s not enough for me to tell them verbally that my blood type is AB+; they need it in writing.

Oddly, none of the blood test results from the lab indicate my blood type.

Luckily, I am a regular plasma donor at the Puget Sound Blood Center, so I can just go to its website, print my donor card, and fax it to the NKR.


My blood donor card. Image from Puget Sound Blood Center

(Hmm, I notice there’s a lack of security/privacy in the PSBC’s donor card web service. Anyone can find another person’s blood type and donor ID number by just knowing some public information about that person. Further, the URL for printing my PSBC donor card is an ASP page with the personalized information encoded in plain text, http://www.psbc.org/_card/index.asp?donor=GEORGE%20%20TANIWAKI&btype=ABPS&code=00757990. I leave it as an exercise for the reader to print their own fake donor ID card. Anyway, why should the NKR trust that my blood type is AB+ just because I send a fax that contains an official looking form rather than a handwritten note or tell them verbally over the phone?)

[Note: This entry was actually written in Sep 2009. I changed the posting date to keep my blog entries in chronological order.]

I’ve finally been contacted by a coordinator at the University of Toledo Medical Center where the Alliance for Paired Donation (APD) is headquartered to confirm my interest in donating a kidney through the never-ending altruistic donor (NEAD) program. Naturally, I say that I am.

Historically, living kidney donors were either a relative or friend of the recipient. However, oftentimes the potential donor is willing to give a kidney, but is incompatible with the recipient due to blood type or antibodies (more on the role of antigens in a later post).

To solve this problem, a set of incompatible donor-recipient pairs can be formed that exchange kidneys across pairs.  The National Kidney Registry and the Alliance for Paired Donation (the two organizations that I have signed up with) are pioneers in matching up these incompatible pairs. In some cases the number of pairs required in the exchange to ensure each recipient gets a compatible kidney can get quite large (more on software used to create chains of compatible donor-recipient pairs in a later post). In order to avoid having a donor break the chain after their loved one has received his/her kidney, the surgeries are performed simultaneously. This restricts the number of pairs that can be in the chain since there is a limit on the number of available operating rooms, surgeons, and other hospital resources.

The need to perform simultaneous surgeries can be reduced, or eliminated, if the first donor in the chain offers to donate their kidney with no recipient in mind. This altruistic donor allows the surgeries to be scheduled one at a time. If any future donor backs out, then the next pair in the chain is no worse off than before. Finally, the length of the chain can be unlimited if the donors never back out. This never-ending altruistic donation is a fairly new development and still rare. But in my mind it shouldn’t be. Why should someone with few friends or relatives be less likely to receive a kidney than someone from a large family or has many friends?