Cheers BladeRunner.
Yep, what you've done looks much like what I submit. I get right down into the large blow-up mode and edit various bits pixel by pixel if I need to. Works well. I typically draw everything up in 1 pixel = 0.1mm scale, and 1 pixel = 0.01mm scale for finer details.
What's also nice is that you can print to scale on an inkjet printer to get an idea of real size, or scale things up on a print-out. Basically it's all one needs IMO.
I also make use of colors to indicate depths. i.e. color red has a depth of xxx, color orange a depth of yyy. When presented as a 2D image, the use of colors makes it fairly clear what's going on even when there are different depth cuts in the drawing.
I just don't see the need for fancy CAD programs and renders. Sure, it looks nice, but waterblocks, even the fairly difficult ones to make, are still quite basic items in terms of geometrical complexity.