In the Hitchhiker's Guide to the Galaxy, Arthur Dent's house is demolished to make room for a bypass just as Earth is similarly demolished to make room for a hyperspacial bypass. The highway construction argument from both sets of construction managers is, "Well, you have to build bypasses."

When we last left our intrepid hero, he was feeling pretty good, having finally recovered from both the tonsillitis and the hospital stay that it had thrown him into. In fact, his most common statement was, "I feel as good as I did before the tonsillitis." But, following the wishes of the local cardiologist as well as his cardiologist of the past three years, he scheduled a follow-up cardiac catheterization to see how far his triple-vessel disease had progressed since the initial diagnosis of stable angina four years before. To do this, he would return to the U.S. Even before getting on the airplane, things began to go sour, as a common cold was contracted that led the entire 24 hours of travel to be less than optimal (and it's not that much fun without being sick). He managed to keep all social and business engagements, however, and arrived in DC on Tuesday night at the same time as his parents, who had expressed a desire to be present for this catheterization (the first one had been scheduled so quickly there hadn't been time for them to arrange travel before it was all over).

The consultation with the cardiologist in his offices on the 24th of September went well, as both patient and doctor seemed to be in agreement that any treatment would depend upon what was seen on the monitor as the medical pigment revealed the extent of blockage in his coronary arteries. The slight lingering cold was no barrier to the procedure proceeding, either, so the next afternoon remained set.

Okay, enough of the third-person narration. I can only keep that up so long outside of the 19th century.

You know it's not good when they get quiet, and they got quiet pretty much as soon as the first bit of dye showed up on the monitor. Rather than having made any progress over the last four years, all the areas where I had blockages had just increased their blocking, kind of like how a river can continue to deposit years after years of silt and debris in places until eventually there's a bit of a natural jam. Oftentimes, when that happens in nature, the river finds a new route, and my body had also been trying to do so by building a collateral network of fine arteries to keep the heart muscle replenished with blood. Unfortunately, that network had based itself off of one major trunk line while the other two were threatening to shut down completely. This is where a graphic can really help save some text.

Your coronary arteries divide into two, left and right. The left also divides into two again, the circumflex (which covers the back of the heart) and the left anterior descending artery. In my case, the right and the circumflex arteries have sections that are nearly 100% blocked (from 4mm to 8mm in length), with the left anterior descending artery squeezed to about 80% in one 12mm section.

That kind of blockage requires some urgent cabbage. Or CABG, as the term is written, standing for Coronary Artery Bypass Graft, known more commonly as "bypass surgery." In my case, I'll have a double. On Monday morning.

And since they haven't proscribed alcohol yet for me, I may have a double before the double.

There's lots of little silver linings in all of this. That heart attack in Malaysia in August could have been much--MUCH--worse. Our home in Silver Spring hasn't sold yet, so I (and Jill and my parents) have an inexpensive place to stay while I recover (and given hotel prices in this city, that's no small thing). After the surgery (well, not right after, but maybe a month later), I should expect to feel a heck of a lot better, with a lot more energy than I've had in years. And, given the length of recovery period, I may have the chance to see my niece compete at a big equestrian show in Pennsylvania during the second week of October.

Okay, so it's not the outcome that I desired, but you have to take the cards dealt to you, and my hand is full of clubs instead of hearts. Given the advances of bypass surgery over the years, while it still has risks, they are entirely reasonable compared to the most likely alternative of my having a massive heart attack if I don't do anything.