First at the money and the years. I had bought a sense of safety, and it turned out to be fiction. All that effort, all that spending, all that doing-it-right, and my arteries didn't get the memo.

Then came something worse: nobody could tell me why. Eight years from clean arteries to one nearly closed. The usual suspects crossed off one by one. Three cardiologists, good ones, and still no clean answer.

At one point, I felt like I was the one keeping the list of possible causes alive, what clinicians call the differential, because I was the one who had to live with whatever hidden risk factors might be missing.

Other than the stent, the plan I was handed comes down to one thing: get my LDL as low as I can. I'm doing it, and the evidence behind it is real. But my LDL was never the high number in the room, and going from a clean scan to a near-total blockage in eight years is abnormally fast for mildly high LDL alone. Something seems missing and I still don't know what.

And here's the part that still keeps me up. I don't get to know for sure that the fix is enough. I changed the things the evidence says matter, but I was already doing enough of them before the blockage showed up to know better than to treat the new plan like a promise.

So when someone tells me this will keep me off a cath table a second time, I hear a hypothesis, not a guarantee.