When that is not an option, I use a bank that has zero foreign transaction fees, and refunded ATM fees. First Republic Bank's ATM refund account, in my case.
BTC seems a bit volatile as a vehicle for transferring between currencies. I personally would want something much more stable if I were transferring any significant amount. If it was just on the order of holiday cash -- and it was convenient to find buyers and sellers -- then maybe, but it seems a lot of trouble to go to!