Ah, it was Christmas a little bit early this year, as my custom shirts arrived from Hong Kong.
The NY Times had an article about a year ago about custom shirts - and they highlighted mytailor.com. Basically you take 20 measurements of yourself, enter them on the website, and then 6 weeks later a custom shirt arrives. Yes, it's expensive (about $80 smacks a pop) - but well worth the insurance of not flying away in a freak wind storm to Canada from all the excess material that would spontaneously create a wind glider. (Have you ever noticed that a "large" shirt is worn by 90% of the male population, and there is enough extra material in the waist to make a small pillowcase?).
Anyway, as you can see - I went with the stripe theme. That's kind of the other thing too - there are about 400 different fabrics to choose from - so not only do you get a cool monogram, but you get a spanky style.
And yes, if you're concerned about taking the measurements yourself - a tailor runs through town about every three months, so you can just visit him to do your measurements. The only problem is that he'll then try to sell you on getting a tailored sportcoat - and they have cashmere - yikes.