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Here's what no one told you about your back pain

The letter from the hospital came on a Tuesday in March. I sat at my kitchen table and did the maths three times. My first appointment with…

the orthopaedic specialist is at the end of May next year. Fourteen months away. Then I did a different sum. The week it came, I was holding the stoep railing with both hands to get down two steps. Fourteen months before that, I was turning the flower bed by the front gate myself, knees in the dirt. That's what fourteen months took. Now they wanted fourteen more. I'm 58. I've run a primary school front office here in Boksburg for 19 years. I'm the one who unlocks at 06:45 and carries the register files. At least, I was. These days I plan my life around my back the way other people plan around load shedding. Hanging the washing means doing the pegs in two shifts. Getting out of bed is a procedure. Roll. Wait. Elbow. Wait. Sit until it eases. And the worst part isn't the pain. It's the measuring. Last winter I could still do this. Last term I could still manage that. Like I'm doing stocktake on myself, and every month something else is missing off the shelf. Two years. Eleven GP visits. He's a kind man, but kind doesn't fix a back. Mybulen at R94.95 a box from the Dis-Chem on Trichardts Road, where the lady doesn't ask anymore. Heat patches that warm the skin and nothing underneath it. A wedge cushion off Takealot for R329, now in the spare room with everything else that was meant to help. When the pain pulled into my hip, he sent me for physio. Four sessions at R690 each, then my savings benefit ran out in May. On the last day she was honest. You need someone to look at this properly. So my GP wrote a referral to the orthopaedic clinic at the provincial hospital. Private was never an option on a hospital plan. Fourteen months for a first consult, a theatre list somewhere beyond that. That night I worked it out. By the time a specialist looks at my back, I'll be nearly 60. And if the next fourteen months do to me what the last fourteen did, I don't know what will be left of me to look at. My daughter Lizelle saw the letter on the fridge that Sunday. She's 32, lives in Benoni. She sends me things. Turmeric. Magnet belts. I say thank you my girl and never open them. On Monday night she sent me an article and phoned to make sure I read it. Ma, this one is different. A girl at her work, Hantie, her mother sat in the same kind of queue at a state clinic and used this the whole time. Hantie says she walked into that appointment better than she'd left her GP a year before. I was sceptical. But the article was by an orthopaedic surgeon, a Dr Schilling from Pretoria, and one line in it made me sit down. He wrote that the biggest mistake people like me make is believing waiting is neutral. That nothing happens to your back in the queue. Something is happening. The discs in your lower back are small cushions of fluid. From your thirties they lose that fluid, fastest when squashed all day. And that is what a day is. Sixteen hours of sitting, standing and lying on them. The discs flatten, the bones drift closer, the nerves lose room. That deep morning stiffness? That, he says, is the cushion going flat. Nothing I was doing touched any of that. Not the Mybulen, which switches the alarm off for a few hours. Not the patches, warmth on the skin puts nothing back inside a disc. Not even the physio, bless her. Stronger muscles around a flattening cushion are still wrapped around a flattening cushion. So the queue is not a pause. Every month on that list the disc loses a little more, and you arrive with less back than the day the referral was written. The waiting itself was the thing taking from me. Fourteen months of it, booked and confirmed, my name spelled correctly at the top. His answer is simple. A disc can draw fluid back in, but only under conditions it almost never gets. The pressure has to come off. It has to be warm. And the muscles around it have to let go so the new spacing holds instead of clamping straight back. All three at the same time. He calls it Triple Fusion. Gentle traction that opens the space between the bones. Deep heat that draws fluid back in while the space is open. Massage that releases the guard muscles so it stays. The device he built is an electric lumbar pillow. Plug it in, lie back for fifteen minutes, and it runs all three at once on your own bed. No appointment, no co-payment, no permission needed. But the sentence that decided it wasn't about pain at all. For people stuck on a waiting list, he wrote, this turns the queue into the window. The months your discs were going to spend going flat become the months they spend filling up again. Lizelle ordered it before I'd finished deciding. The box stood on the spare bed for four days. I didn't want one more thing for that room. Then on Thursday night my back seized while I stood at the sink. Fine, I thought. I've got fourteen months. Might as well find out in week one if this is also nonsense. That first night I lay on it on the duvet, tea going cold. The warmth came through first, deeper than any patch. Then a slow, gentle pulling in my lower back, and somewhere in the middle of it something low down gave a soft click and let go. I won't say I stood up healed. I stood up and everything was quieter. That's the only word. Quieter. The first week was small things. Getting out of bed went back to just getting out of bed. Week two, I hung the entire washing line in one go and only realised after that I hadn't planned any of it. I had to put the basket down for a moment. Week three, Ronel in the front office asked straight out, are you taking something new? You've stopped your little ten o'clock walk to the gate. That walk was how I worked the stiffness out. I'd stopped needing it and hadn't noticed either. Last Saturday I did the flower bed by the front gate. Kneeling pad, hand fork, one bed. I got up off the ground by myself, hands on my own knees, and stood in the sun like I'd won something. Lizelle came for lunch the next day and watched me carry the tea tray out to the stoep. Just, hello Ma, and a smile at the tray. Five weeks. Fifteen minutes a night, after the news. The letter is still on the fridge under the Pick n Pay magnet. I'm keeping that appointment. I want a specialist to look at this properly, and I'll be there at 07:00 with my file. But I've stopped doing the maths at the kitchen table. The date has gone back to being just a date. Whatever is left of me at the end of May next year, it will be more than there was in March. For the first time since that letter, I believe that. I won't promise this will do for you what it did for me. I don't know your back, and I'm not a doctor. I'm a school admin from Boksburg with a letter on the fridge, same as thousands of us. But if you've got a date like mine in your diary. If your benefit ran out months ago and the only plan anyone gave you is wait. If you're lying on the thing that hurts you for sixteen hours a day while your name creeps up a list. Maybe the problem was never your patience. Maybe nobody, in all this waiting, is doing anything for your back. The queue was never going to fix it. It was never meant to. The article Lizelle sent me explains it better than I can: https://archify.co.za/pages/new-breakthrough-in-spine-health Read it before another month on the list goes by. Marlene, Boksburg

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