A different crisis
I've lived for years with an old acquaintance: lower back pain. Nothing dramatic. Every so often a flare-up shows up, I take anti-inflammatories for a few days and go back to my normal life. I suppose it's the consequence of a not-very-advisable combination: martial arts, some bad fall, and forty years of existence.
So when it started hurting this time, I didn't worry too much. Besides, I had the perfect suspect: the bike. It was always a complicated relationship; I like it, but I already knew it sometimes made me pay. So I did what any expert with a degree from the University of Google would do. I self-diagnosed: "It's the bike! Case closed! A couple of naproxen and I'll be good as new."
A week later it was the same. Two weeks later it was worse. And then came the crisis. Not the one where it hurts a little when you get up: I mean the one that looks you in the eye and says "this is as far as we go".
The real culprit
I cut out the bike, temporarily quit sports, and slept on the floor for a few days. And then the real culprit appeared: the mattress. One of those modern foam ones that promise to hug you while you sleep. Truth be told, the first two weeks were spectacular, I slept like a king. The problem is that my back didn't want to be hugged: it wanted support, it wanted springs, it wanted exactly the orthopedic mattress I'd used for years.
Skipping the bureaucracy
By then I had one thing clear: I wasn't going to start the traditional route. I'd done it before —GP, general orthopedist, X-ray, more naproxen, wait—. This time I wanted to go straight to the problem.
So I opened Google Maps and started calling private clinics, one by one. "Do you have a spine specialist?" "No." "Do you have a spine specialist?" "No." Until I found one. "When's the next slot?" "We have an opening in 7 days." "Perfect. Book me."
I didn't know if they took Itapema Saúde, I didn't know how much I'd end up spending, and honestly I didn't care much. When pain reaches a certain point, time is worth more than money.
The specialist
The appointment was just as I imagined. "Move like this, does it hurt?" "Yes." "Now like this, does it hurt?" "Yes." "It's the lumbar region." I mentioned it usually hurts lower down and this time it was higher up. "That can happen too. The CT scan will tell us more." Nothing magical, nothing mysterious: a specialist who saw these cases every day, and that alone was reassuring.
The CT scan: at the speed of light
I had the CT scan done at RSUL. It was Friday and I got a slot for Monday. Something that still surprises me about the region is how fast you can resolve certain things: the wait was minimal.
The scan, lightning fast. What takes time is the results: when I went to pick them up there were more people and it took a bit longer. Nothing serious. But hold on to this detail too, because it's exactly where I messed up.
The follow-up: here's the trap
With the results in hand, a very dangerous thought appeared: "why go back?". I'd already read the internet, already asked ChatGPT, already identified the culprit, already knew I had to change the mattress. In those moments we all turn a little into doctors, mechanics, and financial advisors. Don't do that. Don't be like me.
Here comes what you really have to understand about the system. I waited until I had the scan in hand to rebook the follow-up. Mistake. When I called, the nearest slot was about 15 days later… and it landed a couple of days outside the follow-up window. The result? The follow-up stopped being a follow-up: it was a new appointment, and I paid again.
And notice how strange: the first appointment they gave me in 7 days; the second, in 15. Why so different? I don't know. That's exactly the point: in private clinics there's no consistent rule. Some have follow-ups, some don't, and the timings swing from one to another.
Are they being dishonest?
I don't think so. It's odd that the wait times are so different, yes, but I'd rather not accuse anyone. What I really got wrong was on me: I waited until I had the scan in hand to rebook because I didn't know the system, and that's why I paid for the follow-up.
Now that I know exams come out at the speed of light, the move is different: on my way out of the doctor's, I book the follow-up right there. "Book me for 10 days from now," or less. In my case "book me for next week" would have been plenty, and the scan would arrive well before.
So, what happens if you only use private clinics?
That it's excellent for solving things fast —you find the specialist you actually need and book within a week. Try doing that with your health plan! In Londrina, with a plan and bigger hospitals, it would have cost me far more time to solve, while I was dying of pain and self-medicating like a brute—, but you have to know the rules. Paying for everything à la carte, without understanding the follow-up windows, gets terribly expensive over silly mistakes like mine.
The happy ending, even so, did exist: the specialist reviewed the results and laughed when I asked if sports were over. "What are you talking about? Go to Pilates, take these instructions to your instructor, change the mattress, and in a few months you'll be doing sports again." He was right. I'm still doing Pilates and I don't plan to stop. What I needed most wasn't a medication: it was peace of mind, knowing I wasn't broken. Although, to top it off, the medicines he prescribed turned out to be much gentler on my stomach and work a hundred times better than the naproxen I was downing like a brute.
If you want to see how all this fits into the full picture, head over to how to choose your health plan.
