get_post_meta bringing back results, but $wpdb->postmeta doesn’t

Your SQL query is invalid regarding the WP database structure.

wp_postmeta table has two columns that will help you here.
meta_key : the name of your meta (post_lang in your case)
meta_value : the value of your meta (en, es, …)

Your SQL query should look like this instead.
What changed is that you need to query the wp_postmeta.meta_key column to match your meta name and wp_postmeta.meta_value to match your language.

SELECT p.ID
FROM wp_posts AS p
INNER JOIN wp_postmeta AS pm
WHERE 1=1
AND (p.post_title = %s)
AND (p.post_type="especialidades")
AND (pm.meta_key = 'post_lang')
AND (pm.meta_value = %s)

You could also add the JOIN condition to retrieve only the rows that you need.

SELECT p.ID
FROM wp_posts AS p
INNER JOIN wp_postmeta AS pm ON (p.ID = pm.post_id AND pm.meta_key = 'post_lang' AND pm.meta_value = %s)
WHERE 1=1
AND (p.post_title = %s)
AND (p.post_type="especialidades")

You can try to run this query in your database management tool to see how it works. You can also add a more “human friendly” SELECT clause to better understand the links between the tables.

SELECT p.ID, p.post_title, pm.meta_key, pm.meta_value

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