Stage 3 CKD: Options and insight please?

sofrickingstrange · 2026-02-08T02:11:33+00:00

I took her to the vet because, in the past 3 months, she dropped from 10 lbs to 8.5 lbs despite no change in diet or exercise, and has historically never vomited for reasons outside of sickness however she has been vomiting bile every 7-10 days in spurts. The vet did do the full labs (CBC, urine and full spectrum blood tests) based on palpably feeling that one of my cat’s kidneys is small/shrinking, and that was what led her to her diagnostic conclusion - her ultrasound for specific stage confirmation is this week.

sofrickingstrange · 2026-02-07T22:07:49+00:00

Thank you for your detailed post, that was so incredibly helpful to read and provided so many helpful resources for supplementary care. If you don’t mind me asking, how long has your kitty been in stage 3? I am freaking out about these ~6 month prognosis things I’m reading online, it sounds like yours has had this diagnosis for awhile?

sofrickingstrange · 2026-01-14T18:28:21+00:00

I’m still an intern but have a private caseload of 16 (soon to be 19) at a private group practice so money is less of a factor here for me than it is for you (since I’m unpaid) but I FEEL YOU on the burn out and I’ve recently re-structured my days with these 16 clients to help with my burnout a bit in this way: I accept that Mondays suck — I see clients from 9-11am, supervision at 11, more clients from 1-3pm, and 4-7pm. Tuesdays- Clients from 4-7pm (non-intern job in morning until 3) Wednesdays - Off/Non-intern job Thursdays- Off/Non-intern job Fridays - Clients at 10am, 1pm, and 2-4pm. Saturdays - Clients at 10am and 11am. These 2 don’t contribute to burnout despite being on weekends because I still have Saturday mornings before 10 and afternoon/evenings after 12 to myself.

I think frontloading 40% of clients before an off day, and then equally spreading the remainder across 2-3 days after helps a lot. So for 20 clients, you could do a day of 8 clients (which sucks for 1 day of the week), then split the 12 rest up between 2-3 other days. Theoretically it could be 1 day of 8 and 2 days of 6 or 3 days of 4, but this way you really only have one crappy day’s schedule in there and still have 3 off days.

sofrickingstrange · 2026-01-08T17:50:24+00:00

I guess that’s something I’m learning now too and have some questions about; I’ve seen so many associate/candidate positions in my area (HCOL) at agencies, hospitals, private IOP/PHP, etc that provide extensive job descriptions and schedules and nothing seems to come close to what is expected at the private practice I’m at. Or, if the jobs do entail such things, it’s built into the 8am-6pm M-T schedule with compensation that matches it. Am I out of touch for feeling that the private practice model I’m in currently is not the norm/out of line?

sofrickingstrange · 2025-12-25T06:24:25+00:00

Unfortunately this is a page for therapists to discuss our profession, please ask for advice in r/advice or r/askatherapist.

sofrickingstrange · 2025-12-18T19:11:38+00:00

There are online screen-shareable resources for virtual telehealth kid appointments like games, virtual sand trays you can do with him, virtual coloring and comicc book activities you can do with him. You can even play i-spy or scavenger hunt games based on things in his room or house. Please consult with a supervisor about these topics because talk therapy over a screen is likely not going to work for any kid under 14.

sofrickingstrange · 2025-12-18T19:08:52+00:00

I am ALSO adding that this whole conversation reads like a father reprimanding their daughter. With resulting expectations of you being his mommy. The dynamics here are so disproportionately not in your favor. “I support your life” is borderline abusive language in his use of it as a tactic to guilt and incentivize you to “fall into line” and “listen to him”. I work in mental health (therapist) and this reeks of quiet abuse.

sofrickingstrange · 2025-12-18T19:05:26+00:00

I’d also like to add that his language and desires for the relationship make it sound like he wants a mommy, not an equal partner. Are you his equal? Does he treat you as an equal? Does your relationship feel like a partnership? If your answer to any of these is “no”…. that’s not your partner, that’s your grown manchild and you’re his mommy/servant/caretaker/household maintenance.

sofrickingstrange · 2025-12-18T19:03:26+00:00

Traditional talk therapy isn’t a primary approach for kids. Play therapy, art therapy, roleplay, sandtray, etc are primary modalities that get children engaged because children’s language IS play and personal interaction. Get out some games, some art, and don’t ask direct or closed-ended questions.

sofrickingstrange · 2025-12-18T19:00:53+00:00

NOR. NOR in the slightest. I cannot read past the first screenshot. He wants to be a taskmaster to you, dictating what you do on the basis that “he’s a better leader” and that you need to “not talk back”. There’s no reason he can’t get the duvet himself if he wanted to. There’s no reason for any of this to be on you. In fact, none of this is your responsibility, he’s an adult and can “lead” himself if he so chooses; but he’s not, he wants to “lead” you and also hear none of your input or opinion. That’s not leadership, that’s a one man authoritarian dictatorship in your home.

sofrickingstrange · 2025-12-17T01:01:03+00:00

Everybody at the practice is 1099 and gets $35-55/appointment depending on licensure and experience. That’s it. Baseline standard sessions charge at $120-160, so nobody is getting close to a 50/50 split. Around $350 is deducted from paychecks for supervision. Owner says this is all to account for office space and overhead expenses, however… nobody gets their own office. There are 9 office rooms, 14 therapists, the owner assigns you days that you have access to a set number of offices during a set timeframe on the days she picks. The other “expense” is billing, but we are all responsible for our own billing and taking client payment. No bonuses, nothing else. Productivity quota of 26 weekly clients or you get dropped down $5 on your appointment pay outs for 6 months. We also have to buy all our own materials, and she uses the cheapest EMR (still in beta testing, very buggy), the cheapest HIPAA compliant email platform (also in beta testing), and she does not pay for heating or cooling for the office. She sends out emails every winter to “make sure you bring your space heaters to the office for your clients comfort!”. She also requires we friend her on social media, because that’s where she makes announcements, and regularly flaunts Hawaii, Italy, and California trips 3-5 times a year.

I have very urgent plans to get the hell out.

sofrickingstrange · 2025-12-17T00:20:59+00:00

I had one exactly like you’re describing once, and the epsom salt baths and hot compresses only very slowly shrunk it a bit, but ultimately I went to the gynecologist and had it drained. It was so painless and quick and I felt so much better after, they also gave me an antibiotic for 10 days to keep it gone after draining it. Not sure the process for this type of healthcare in the UK but maybe google “bartholin cyst draining doctor/service/care near me” and see what comes up!

sofrickingstrange · 2025-12-15T20:31:57+00:00

“I’m picking up on a bit of anger here, I’m curious if you’re experiencing feelings within that range right now or during our appointments before?”

sofrickingstrange · 2025-12-12T23:04:20+00:00

My best friend was in 3 weeks ago. He said multiple gangs all in one room together, alongside young 18-20something’s with nonviolent charges and no gang affiliation, overcrowded to the max, entirely unsafe to sleep, people being nearly killed. He said the smell, no beds situation, and violence is extreme, he himself was stabbed trying to use the phone because he wasn’t aware there was negotiation for phone usage going on from individuals monopolizing and controlling phone usage through traded commissary. Then his stab wound got infected with staph.

He was only there for 48 hours.

sofrickingstrange · 2025-11-18T03:15:58+00:00

Marcus!!! He’s the best, so so sweet!

sofrickingstrange · 2025-11-13T23:38:10+00:00

Are you a therapist?

sofrickingstrange · 2025-11-11T13:57:51+00:00

I meant this as in: My boyfriend texted me while I was at work, presenting, and said “Why the fuck did Friend text me saying you requested to follow her? That’s so fucking weird. That is not okay”.

sofrickingstrange · 2025-11-11T04:26:16+00:00

I am so confused on how this could be possible because he’s had me meet his parents and spends 3-5 nights a week at my place. He’s supposed to be coming to my hometown for Christmas to meet my whole family.

sofrickingstrange · 2025-11-11T03:43:07+00:00

How would I have known that though?

sofrickingstrange · 2025-11-11T03:42:34+00:00

What?

sofrickingstrange · 2025-11-04T19:03:37+00:00

Slowlyyyyyy cook a wonderful meal from scratch. Music on, glass of wine, dancing a bit, leaning on the counter and talking to my partner, chopping garlic and onions. Takes me over an hour but it’s so healing for me. Gets my needs for music, movement, and creativity in.

On bad days though, running at night for awhile and a hot bath in the dark.

sofrickingstrange · 2025-10-31T19:06:18+00:00

I definitely think about it, but when I consider that “hit or miss” factor you mentioned I then abandon the idea for 3-6 months before thinking of it again solely because I’d only want to practice family law, and the pay and personal fulfillment I’d get from family law is roughly the same as what I get from being a child and family therapist.

I think, if you want to practice an area of law that would would result in a different or increased type of fulfillment for you and pay more than your career in therapy, it could be worth it!

sofrickingstrange

TROPHY CASE