Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Monday, March 14, 2016

Medical Tourism Fall-out

"It's almost like your stomach ruptures. [Complications can be a nightmare to manage and repair] because we don't really know what they've had done. There's no real operative report; we don't know exactly what happened elsewhere. It's hard for us to figure out what was done, and how to fix it."
"[As example, a woman in her 20s had to have] essentially her entire stomach [along with part of her esophagus removed] after undergoing surgery in Mexico."
"The stigma [of obesity] is that these people just eat too much and don't exercise enough and they can fix themselves. The reality is, it's a significant problem and when people become severely obese it is very hard to 'fix'."
Dr. Shahzeer Karmali, associate professor of surgery, University of Alberta
Katherine Halstead flew to Tijuana, Mexico for a procedure to lose weight, in 2014 but ended up in hospital in Richmond, B.C. where doctors tried to repair the damage -- Still from video

The world has become a smaller place with the ease of travel. People shop around for cheaper prices on all manner of consumer products, thinking nothing of travelling across borders in North America, from Canada to the United States in belief that it's worth their while even shopping for pedestrian consumer goods; household products and food items, even gas. With the Canadian dollar shrinking in value those cross-border shopping trips have been curtailed, but as soon as the Canadian dollar gains strength again, so will the volume of those trips.

People gain satisfaction with the belief that they have scored a bargain, one can only suppose, imagining that the expenditure of their time and the energy it takes to travel to a foreign destination balance out well against the bargains awaiting them. And the same can be true of medical procedures. India, China, Mexico, Costa Rica, South America all offer bargains at their hospitals for medical procedures that are costlier at home, complicated by the fact that in Canada there are long waiting lists.

A new research study into the growth of "bariatric medical tourists" had researchers survey Alberta surgeons on the complications people who have travelled to Mexico and other destinations for cut-rate bariatric surgery are presenting with. Katherine Halstead, who returned to Canada only to find that she needed emergency medical care, experienced complications when the staples in her stomach failed and it was revealed that at the Mexican clinic doctors accidentally split her spleen during the procedure.

Canada's long wait lists for obesity surgery has convinced people to venture abroad for treatment of their obesity, yet when they do so there is no long-term post-surgical care. Canadian doctors and surgeons see the results of surgeries gone wrong or complications arising from the surgeries. Obese Canadians are increasingly turning to medical travel companies and websites to usher them toward a holiday with a medical connection. 

They're lured by attractions such as private pre-operative chauffeurs, by "shopping and sightseeing" and staying over at four-star hotels and resorts where they can rest up after surgery. Gastric bypass surgery, the stomach stapled down to a small pouch can be had for $5,900 abroad as compared to similar surgery in Canada at a private clinic outside provincial universal health care where the cost is $19,500. 

For many patients the return trip home lacks the glamour of the trip and the hope of swift recovery and a solution to their obese state, when leakages where intestinal contents make their way through surgical staples into the abdominal cavity leading to potential life-threatening sepsis can occur. The 20-year-old woman who had returned from her Mexican surgery will now need to be fed through a feeding tube for the rest of her life.

In Canada, wait lists for stomach surgery average five years. Even so, only one percent of eligible patients present as candidates for surgery. "Consequently, many patients turn to medical tourism despite potentially severe complications", wrote the Alberta researchers in the Canadian Journal of Surgery. A complication rate of between 42 to 56 percent has been noted for out-of-country weight loss surgery.

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