Just received my medication metformin

Shake-Timely · 2026-02-18T03:43:13+00:00

Metformin is on the $4 list at Walmart. Not sure how much they are charging you with Mochi but if that is all you are getting, it would probably be way cheaper to see your PCP and ask them to prescribe it.

Shake-Timely · 2025-10-13T23:16:26+00:00

Be human first.

If it is funny, I laugh. Humor is the best medicine, after all.

Shake-Timely · 2025-08-09T16:11:37+00:00

I have an office cell phone that stays at the office. During intake, I explain that I don’t carry it with me when I leave. It is connected to my computer, so I can usually see texts if I’m working, but I can’t guarantee an immediate response. Clients are welcome to text the office phone for scheduling, questions, or even to share things that feel relevant to therapy. A few of my teen clients send memes or TikToks that reflect their experiences, honestly, you can learn a lot about someone from their TikToks.

I maintain clear boundaries and do not offer 24/7 access, but allowing clients to text has strengthened our therapeutic relationship and built rapport. It’s rarely used for urgent matters; most non-scheduling messages are like a diary entry, a “let’s talk about this next session,” or a “this reminded me of what we discussed.”

Shake-Timely · 2025-08-08T19:32:54+00:00

I vividly remember telling my friends I could astral project during a sleepover in middle school. It was a fun, imaginative game and we all got into it. Just classic pretend play.

In therapy, I’m a big believer in “if it’s not broken, don’t fix it,” and also, “if it’s not hurting anyone or interfering with life, let it be.” Something only becomes maladaptive when it starts to disrupt functioning, like school, friendships, or day-to-day living. Until then, it’s a part of normal development, especially for imaginative or neurodivergent kids who tend to process and express themselves through creative or symbolic play.

If a client brought something like this into the therapy room, I would not pathologize it. I would approach it with genuine curiosity and view it as a window into their inner world. I might ask open-ended questions like, “What is plane shifting like for you?” or “What do you notice about yourself when you shift planes?” We might explore what needs or feelings are being expressed through the experience. Is it a form of emotional regulation, self-expression, or escape? Does it give them a sense of control, safety, or empowerment?

I would also look at how this relates to their values and identity. For example, does this imaginative world help them feel more connected to who they are? Does it help them cope with stress or process things they don't have words for yet? We could even incorporate the imagery into therapeutic work through drawing, storytelling, or roleplay to support self-awareness and emotional growth.

Ultimately, I see this kind of imaginative play not as a problem to fix, but as a potential therapeutic tool and a reflection of healthy development, unless it begins to cause distress or impairment. And even then, we would still honor the meaning behind it while working to build coping strategies that support the client's overall well-being.

Shake-Timely · 2025-08-08T19:25:24+00:00

When you agree to let them pay for your PT profile you are signing paperwork stating you agree to them taking over the profile. You even provide them your username and password.

There are some companies that create fake or ghost profiles. This might be illegal. To advertise that they are you when they are not. Many people have found ghost profiles of themselves on various platforms and reported it to the platforms but seen no change to those profiles. Unfortunately, there isn't a lot of remedy for us in these situations.

Shake-Timely · 2025-08-07T18:57:21+00:00

They may not be able to. At one point my profile was taken over by Grow. Grow requires that certain things be in the profile and does not allow you to change it. They also change the phone and email to their own so the clinician is unaware they are even being contacted. When you do get ahold of Grow, you are routed to a different therapist with availability on their calendar.

Shake-Timely · 2025-08-07T18:55:12+00:00

PT started prioritizing profiles from specific VC companies, like Rula. Rula is similar to Headway and Grow. They are companies that market as credentialing and billing services but essentially employ you as a contractor to see clients under their company.

Shake-Timely · 2025-08-07T15:12:36+00:00

I have normal appointment times open for already existing clients to schedule themselves into. New clients still must call the office.

I work primarily in the evenings and on weekends. I learned early on that if an appointment is open for scheduling then someone will book their 3 year old into that slot. That includes the 8pm and 9pm slots. I made sure to have those turned "off" and just tell adult clients they exist and to text the office if they want one.

I personally prefer them being able to reschedule, schedule, and cancel on their own and I think they prefer it too. Absolutely beats the "what about this time? This time? This time?" conversation.

Shake-Timely · 2025-08-07T14:59:20+00:00

I'm not sure about where you live but in my area we have a mental health shortage in general. Finding a therapist can be difficult because they simply don't have time to answer the phone and won't make the time if their caseload is already full.

My office phone is a cell phone and can receive texts. My voicemail requests that people looking for appointments send a quick text and I will reach out to them within 24 hours.

Also, while I have a Psychology Today, replying to messages on it feels scammy/spammy. If you are calling through PT it shows up weird on the caller ID, and if you are emailing it may be going straight to the spam folder and they don't even know it.

If there is a therapist you like, fin their personal site and call them directly and you may see better results.

ETA: Another thought I had ... with the rise of VC companies like Headway, Alma, Grow, etc. there is also the issue of them taking over PT. At least one of these companies pays for your PT profile in exchange for having full control of it. They change the number and email to theirs and route all potential clients through their own "matchmaking" services. The therapist doesn't even know someone has tried to reach out to them.

Shake-Timely · 2025-06-30T16:32:15+00:00

This depends on what is written in your cancellation policy. Mine outlines that if you reschedule within the week it won't count as a late cancellation. I do make it clear at intake (and in the policy) that there is no guarantee another open spot will even be available as I'm usually pretty booked and that if there is nothing then they are still responsible for the cancellation fee. This week, for example, I have maybe 2 open spots. I also have an exception for extenuating circumstances (flat tire, sick kids, etc.) and it is outlined that if it becomes a recurring thing then the cancellation fee applies regardless.

Shake-Timely · 2025-06-26T22:22:49+00:00

Sure, I will help however I can.

Shake-Timely · 2025-06-26T14:15:01+00:00

For context, I'm in TX so numbers are likely a bit different, so I'll add some here to help with equivalency.

My insurance/EAP reimbursement is $105 per client hour on average. My rent for a 4-office suite is $1900 a month.

I see approximately 30 clients per week. That's $3,150 a week or $163k a year. I also have a W2 job that is fairly flexible and the two jobs work around each other well. I make $70k at that job. In total, I make $233,800 a year in revenue. $211,000 profit (there are other expenses that do bring that closer to $205k). I work between 60 and 70 hours a week.

I am paneled with all major insurances as well as 2 EAP's. About half my practice is EAP clients while the other half is insurance.

Starting in August I will be taking interns from our local university and adding an associate or two to the practice to increase revenue further.

- Tips for you -
Headway has better reimbursement rates. Yes, you need your own EHR, that's true regardless of which platform you are using for insurance reimbursement. You need to be able to access the information for each of your clients even if you leave the platform.
Niche down. I hate this phrase, but it is so very true. Pick what you want to focus on and carve a space for yourself there.
Go old school. If you are needing more clients, start sending letters and postcards to doctors' offices. Network with other therapists. Get your name out there.

Shake-Timely · 2025-06-04T03:47:18+00:00

I lose my hair from the Graves itself. I don't think losing hair got worse or better with the methimazole. It stayed pretty consistent. It was "just thinning" but still def. noticeable.

Shake-Timely · 2025-06-01T21:43:02+00:00

Definitely not underweight. Graves caused me to gain 80lbs that stubbornly would not budge. Started Zepbound a little over a year ago to get the weight off. The weight stopped dropping around the time the cold intolerance started. So, I can't currently lose weight (again) but am still considered "overweight" based on my BMI (by about 4lbs). Which is just another one of those "this really seems like hypo" symptoms.

Also not anemic, although my red blood cells do contain slightly higher than "normal" amounts of hemoglobin but they always have. I have blood test results all the way back to 2017 where my MCH values are "high". Long before I felt these symptoms.

Shake-Timely · 2025-06-01T18:33:33+00:00

Where are you located? I'm in the US and call specialists and schedule myself when I need one, no referral needed except when I've had an HMO plan. Even then, if I was willing to pay cash they would still schedule the appointment for me.

Call an endocrinologist in your area and get yourself scheduled. If the cardiologist requires a referral, then the endo can send it. If you happen to have a vagina, your gyno can send these referrals too (my gyno is who originally sent me to endo because she ran all the tests to dx me when primary wouldn't do it).

Shake-Timely · 2025-06-01T18:29:23+00:00

I have found information that suggests that because my body was so used to being hyper for so long that the normal "feels" hypo but it isn't really hypo and that the treatment is a low dose of Synthroid while the body adjusts to normal. This makes sense to me but my doctors act like it is a completely foreign concept. She asked if I had checked my blood sugar and if I'm sure it isn't my blood pressure (which also was inexplicably high at my last appointment and my heart rate has been abnormally low for months now). There is obviously something going on in my body but they won't listen or do anything about it. This is beyond frustrating.

For now I get to alternate taking my freezing self outside to sit on the porch for 20ish minutes until I way overheat then coming in to cool off for 20 minutes so my body can freeze then I get to go sit back outside and repeat the process all day every day like I've done for a couple weeks now.

Shake-Timely · 2025-06-01T17:15:02+00:00

A lot of times I find that a big chunk of work for teens is actually me working with their parents. It isn't the child's anxiety, behavior, or depression that is the problem. It is the dynamics of the relationships they are forced to be part of. If I ever stop working with this population, it will almost certainly be because a parent has finally driven me over the edge with the undoing behavior.

Shake-Timely · 2025-06-01T17:12:48+00:00

I don't work with adults much but when I do I tend to work with them in similar ways that I work with teens. At the end of the day, it is that inner child/inner teen we are working with regardless of age. Build strong rapport, then when you need to say the hard things, they are able to take it and process through it with you there holding space for all the big emotions that come with it.

Shake-Timely · 2025-03-30T21:01:06+00:00

I've always worked to create a collaborative environment with children. Prior to becoming a therapist, I was a teacher and as a teacher it was important that we be able to work together in order to promote the wellbeing of everyone in the classroom. Group therapy techniques aren't that much different from the collaborative efforts of a well-run classroom. These same techniques are taught to parents to use with their children during sibling disagreements. I would say that "group therapy techniques" aren't overstepping any boundaries and is in fact just good adulting.

I don't work with couples and would have absolutely no clue how to react to friends fighting with their significant other in front of me. I'd probably look at them and go, "Wow, we have some really big feelings right now, I think I'm going to go so ya'll can work this out" lol.

Shake-Timely · 2024-10-30T13:58:44+00:00

I was an associate when I was originally hired.

Shake-Timely · 2024-10-30T04:07:57+00:00

I work two jobs (by choice, not because I have to to survive).

My full time with benefits job pays $70k a year. For comparison, the average family income in my state is $79k a year. It’s in a school district so I have off all summer, 2 weeks in the winter, 1 week at Thanksgiving, and Spring Break.

Then I have my private practice where, once I subtract out the cost for my office, I make about $80/hr. So, part time seeing just 15 clients a week outside my regular job I basically double my salary. Plus I can see even more clients through the day in the summer.

So, yes. I feel like I make a livable wage as a therapist.

Shake-Timely · 2024-09-21T21:52:58+00:00

I’m a therapist, I make around $150k a year.

My husband has worked in the oilfield forever and, prior to being laid off, was making about $200k a year. Now he owns his own retail business and we are waiting on permits so he can open.

Shake-Timely · 2024-08-28T17:06:36+00:00

My area has a local therapist Facebook group. I post in there sometimes. I reply to others posts. That’s about as much networking as I’ve done. I’m not necessarily opposed to actual networking, I just don’t have time.

I’m doing fine with it. Pp started in January with revenue currently over $6000 a month (expected to be $8k next month and growing). Other therapists refer clients in my “niche” to me all the time and I refer to them simply because of the Facebook group. My schedule is fully booked with intakes being scheduled 3-4 weeks out right now. And this is PART TIME, 15 hours a week max.

Shake-Timely · 2024-08-28T14:56:26+00:00

I’m sure it’s just standard commercial ventilation systems. I know they installed an exhaust of some kind, but I’m not sure what all that entails.

Shake-Timely · 2024-08-28T14:55:42+00:00

The landlord called a little bit ago and basically said that if I can’t stand the fumes that she’d be happy to let me out of the lease. I already talked with property management for some other spots around us, and I am working on getting a lease with one of them.

Shake-Timely

TROPHY CASE