When Victoria resident Nanci Walsh's weight shot up to 300 pounds, she decided to take a drastic step to save her life.
A series of major life challenges ranging from the sudden death of her father to a stressful lawsuit had led Walsh from being a life-long "bigger girl" to quickly putting on 80 pounds and sliding into obesity.
The weight gain triggered debilitating sleep apnea that required her to be hooked up to a ventilator at night, and her doctor told her she was likely facing diabetes as well.
She inquired about getting bariatric surgery — also known as gastric-bypass surgery — to help her lose weight.
But the wait for her in B.C. for this surgery was five to seven years. So in 2012, Walsh took matters into her own hands. After some online research, she flew to Puerto Vallarta, Mexico to get it done there.
According to a recent report from conservative think tank the Fraser Institute, Walsh is part of an increasing number of Canadians seeking medical treatment abroad.
The study has sparked debate about the adequacy of Canadian medical services and what really drives Canadians to risk going under the knife outside the country.
The Fraser Institute report says an estimated 63,459 Canadians received non-emergency medical treatment outside Canada last year, a steady increase over previous numbers. And B.C. appears to be leading the country with the highest percentage of patients — 2.4 per cent — doing so.
More choices, says think tank
The report's authors say the rising numbers are emblematic of the lack of private options in the Canadian health care system, which can lead to longer wait times.
But critics have bristled at the study's findings and the Fraser Institute's interpretation of them.
Jeremy Snyder, a member of SFU's Medical Tourism Research Group, said many Canadian patients seek medical treatment abroad for a range of reasons. "There's really no foundation for concluding that the primary cause of medical tourism by Canadians is due to wait times," Snyder said.
Yanick Labrie, a senior fellow with the Fraser Institute, disagreed.
"Why would they [go abroad] if they were able to get their treatment in a timely manner in Canada for free?" Labrie asked.
'Blunt and nasty'
Back when she spoke with a specialist about getting bariatric surgery to help her lose weight, he told her it would be years before she could get the procedure done. He told her she wasn't a good candidate for it because she was an emotional eater.
"He was very blunt and nasty about it," Walsh said. "I think he doesn't realize how close he had put me to suicide."
She says getting the operation done abroad was the best decision she has ever made.
The $5,000 price tag included a one-week stay for her and a guest at a five-star resort, medical files in English for her GP back home, and monthly follow-up phone calls for a year.
Nurses in starched white uniforms walked the halls of the modern hospital, in the same highrise as a casino in a gated community, and doctors spoke to her in perfect English.
"It was the cleanest hospital I've ever been in in my life," she said.
The result, five years later, has been a sustained loss of about 120 pounds
But not everyone who receives medical treatment abroad receives gold-standard treatment, Snyder said, arguing that patients are taking great risks by potentially encountering sub-par treatment abroad.
And patients returning home with botched surgeries can end up costing Canadian taxpayers more money — one study suggests medical tourism cost the Alberta health system $560,000 in one year.
"A lot of times the care is great but there are some horror stories as well," Snyder said.
He also questions how the Fraser Institute's numbers are gathered — by asking specialists to guess how many of their patients sought treatment internationally in the past year, and then extrapolating the larger number from those results.
Health authorities don't track the issue.
'He really wanted to try it'
Based on interviews Snyder has conducted with Canadians who have gone abroad for treatment, he thinks there are many reasons that drive them to do so.
Snyder said many Canadians also go abroad to seek cheaper options for expensive elective surgeries, procedures that aren't legal in Canada (like paid surrogacy), or experimental treatment.
The latter is what lead Canadian folk-rock icon John Mann to get unproven stem cell treatment in Mexico last January for the early onset Alzheimer's he was diagnosed with.
"It's just so terrifying, the prospect of knowing what's going to happen with you with Alzheimer's," said Jill Daum, Mann's wife.
"For John, it was if there was even the tiniest chance that this might help, then he really wanted to try it."
The couple raised more than $56,784 US to cover costs for the treatment, which included spinal and intravenous stem cell injections and vitamin therapy at a clinic in Tijuana, Mexico.
Daum said there's no way they would have gone into debt to pay for the treatment themselves.
"If stem cells cured Alzheimer's, we would know," Daum said. "Everybody knew it was a long shot."
Daum doesn't think the costly therapy made much of a difference. But it did give Mann a boost of confidence as he slogged his way through the last concerts he would ever play.
"I think it gave him three months of hope," she said. "He really literally had nothing to lose."