For months, Peter Joy spent part of each day soaking his aching foot in a bucket of ice water to help ease the burning pain.
He couldn't work. He couldn't walk. He couldn't even swim — one of his preferred types of exercise — because of the excruciating pain in the big toe of his left foot.
"Even the resistance with kicking in the water would increase the toe pain," he said. "My life was taken away from me."
Joy was put on a referral list in November to see the first available surgeon, and was then told in February he would have to wait up to 18 months for surgery in B.C. to treat the osteoarthritis at the base of the toe.
"It crushed me," said Joy, a Surrey psychologist who specializes in pain.
Unwilling to wait more than a year, Joy chose to pay nearly $12,000 US for surgery in Seattle, Wash., in April of this year.
Until he had his procedure, Joy was among the thousands of British Columbians waiting for elective surgery. Right now, just over 88,300 patients are on B.C.'s surgery waitlists. Some of the longest waits are for orthopedic surgeries, the kind Joy was waiting for.
Daily pain too much to bear
The waits are due in part to the pandemic, which caused elective surgeries like orthopedic surgery to be put on hold.
Orthopedic surgeons have told CBC News that the pandemic and natural disasters, namely B.C.'s floods and wildfires, have also exacerbated staff shortages. Doctors also say there aren't enough beds.
The province says it's aware of the long waits and that it is trying to address the problem by opening new operating rooms and hiring more staff, including surgeons, nurses and anesthesiologists.
But the changes didn't come soon enough for Joy, who said the daily pain was too much to bear.
"I was getting really depressed," said Joy, who has been a practising psychologist for over 30 years.
Joy said he contacted a private clinic in Vancouver but was told he did not qualify for private orthopedic surgery in-province.
He looked into paying for surgery in another province, but decided that driving to Seattle for the consultation, surgery, and follow-ups would be more convenient than options in Calgary or Toronto, neither of which responded promptly to his inquiries.
Total costs for Seattle, including travel and accommodation, were comparable with the Canadian out-of-province options, he said.
Dr. Sarah Jurek, an orthopedic surgeon in Seattle, says she's seen a small uptick in Canadian clients during the pandemic.
"I never had a Canadian patient before and I've had three [in the past eight months]," she said.
Long wait times were cited by at least one of her Canadian patients as the primary reason he travelled to the U.S. for surgery.
Finding relief abroad
Other British Columbians have flown across the world to relieve their pain.
Lauren Swans, a recreation therapist in Vancouver, was diagnosed with degenerative disc disease last year.
She said she experienced severe nerve pain in her lower back, pelvis and legs that presented as burning or tingling sensations.
"I had excruciating pain all day."
In March 2021 she was put on a surgery waitlist and was later told the earliest she could get the elective surgery was June 2022. But even that was unlikely, she said.
"My mental health was so impacted that my family and friends weren't sure if I waited to get surgery, if I would still be here," she said.
After months of waiting, she decided to travel to France for surgery in February, paying $30,000, inclusive of travel and accommodation costs.
"Our medical system was unable to support my needs," she said.
A calculated risk
Patients may consider leaving Canada for surgery because they feel it's quicker to access or the quality is better elsewhere, says Jason Sutherland, director of the University of British Columbia's Centre for Health Services and Policy Research.
But Sutherland cautions that adverse outcomes, such as post-surgery infections, can cause costs to mount for those getting surgery outside of Canada.
"If left untreated … if you're discharged from a foreign hospital, you can get really sick from that," he said.
He adds that getting surgery abroad can still also mean having to wait a long time for rehabilitation when they return to B.C.
Still, patients opting to leave the country for surgery is a reflection of "a failing system," said Dr. Cassandra Lane Dielwart, president-elect of the British Columbia Orthopaedic Association.
Dr. Dielwart has described a "surgical crisis" in B.C., noting patients are losing jobs, getting addicted to narcotics, and getting depressed as they wait for surgery.
Joy and Swan say their out-of-country experiences reflect the frustration felt by thousands of people waiting in pain for surgeries within B.C.'s public health-care system.
"Part of me is really angry about how our health-care system is letting down so many who are suffering," said Joy.