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[Music].hi welcome to wellness Woodbridge I'm.your host and maza of veto Meza salon.and spa as well as hair and scalp.wellness I'm here in Edison today at the.Johnson Rehabilitation Center here at.JFK also hackensack meridian health and.we're going to meet with some great pain.manage specialists and rehabilitation.specialists here today answering some.great wellness questions for you I'm.sure we all have some things that we.could utilize some help from.rehabilitation and pain management so.thanks so much for joining us and we'll.look forward to a great show so now.we're here with dr. Sagar Parikh who's.the director of this beautiful facility.doctor tell us a little bit about what.you do here first of all thanks for.coming so we're part of a group called.the center for sports and spine medicine.and we're housed under hackensack.meridian health and specifically part of.the JFK johnson rehabilitation institute.i know that's a mouthful but so.essentially the JFK johnson.rehabilitation institute is a.world-renowned rehabilitation facility.and specifically what we do is physical.medicine and rehabilitation it's a field.of medicine that we take where we take.care of disabilities dysfunctions pain.injuries of certain degree and what we.try to do is rehabilitate them back to.some function back to their life and so.mot our subset of that the Center for.sports in spine medicine specifically.deals with musculoskeletal injuries.sports injuries pain conditions almost.non-surgical orthopedic conditions.that's inhibiting someone from from.enjoying their daily life so our goal is.to employ an arsenal of different types.of techniques to help bring them back to.function that's wonderful so you deal.mostly with orthopedics but you're here.in this area but you have people.probably traveling far to come to you.for these services sounds very.specialized sure I mean the one thing.what I love about this Center.specifically is that we truly take care.of the patient holistically what that.means is of course we have our team of.physicians that are either sports.medicine trained or pain.and trained all of us are trained under.the rehab rehab medicine sort of mindset.so so we have our team of physicians but.we also have our team of physical.therapists occupational therapists we.have our mind body experts we have.specialists in nerve conduction studies.in EMG and we have so we have every one.of us is sort of exercise minded and.functionally minded and we work together.to sort of rebuild someone back to some.sort of physical function and and and.some sort of quality of life so.hopefully even sometimes to prevent.surgery but if surgery is required.you're helping people after that as well.100% what we like to see is we like to.see ourselves as coaches you know we're.trying to coach someone through their.injury through all aspects so oftentimes.when someone to come and see us they'll.obviously they'll be loaded with.questions on on their arthritis of their.back pain or their shoulder pain or.anything of that sort and what we like.to do is not just to diagnose them and.also provide them in some sort of.treatments but also guide them through.the natural course of their of their.condition what are they going to expect.maybe after an image guided injection.what are they going to expect after.physical therapy what can they expect.when they're done with physical therapy.and we want to now connect them with an.athletic trainer so we're really trying.to empower them with as much knowledge.as possible to get them back to.independence so looking at the body as a.whole it can be so amazing the way you.can heal itself and you're able to do.that as a team and facilitate to each.individual case for whatever the needs.are 100% correct and so I mean I'll give.you an example of such in one of the one.of the biggest causes of disability and.decreased quality of life in our country.is lower back pain that's a huge issue.so if I don't mind I'm gonna bring the.spine model out here so we know of no.lower back so make believe this is a.lower back course we have the front of.the body we have the back of the body.here and so what we will complete epicly.know is that well we have a series of.bones discs we have nerves that come out.of the spine and we have certain joints.in the spine as well any one of these.things can cause back pain but we don't.often.dressed and what we should and what we.try to do more often now is in addition.to the spine there's also muscles.there's also ligaments that you don't.see on this model there's also let's say.a lot of us have a gut there's a gut in.front so in order to actually practice.good spine health and good back pain.relief we need to offer them the the.gamut of treatments that being proper.diagnosis first perhaps an image guided.injection to one of these areas to.relieve some pain well we also want to.coach them on proper eating habits we.want to lose that gut we want to build.that muscular core around that spine to.help preserve it we want to enforce.proper biomechanics so all of this.together deals with wellness so it's not.just let's say an injection it's not.just let's say a medication to help me.it's it's let's lose that weight let's.build up that core let's improve your.sleep so we're gonna add and let's let's.work on some mind-body relaxation.sometimes so we're working through all.of these things together to help improve.some quality of life.well it sounds great it's holistic it's.it's exactly what we're all about on.this wellness show just providing you.know the clients with that knowledge and.that education so that they can do these.things and and be a partnership with the.doctor not just go to get fixed it's a.different mind frame and that's what's.changed I think so much in our society.now I think you touched upon something.really great is so what I often tell.patients is this is we are the coaches.and we're gonna guide you through.through this whole process but it's.almost 30 percent us and it's 70 percent.you so you know what we can guide you.for as much as we can but we need some.motivate you to do the rest and and so.the nice thing about this facility again.also is that we're part of an academic.center so every so often we do have.students and we have residents and we.teach but and in doing so the nice thing.about is we can spend sometimes 30.minutes or the patient and really go.through that whole aspect of the.education because education is part of.our part of its within our bones in this.institution and so we actually love.doing that well it's so great that.you're here.so close to us so close to Woodbridge.Edison that's always been a great.location for us so we're excited that.you're here that you can help facilitate.to this community thank you so much and.I can't wait to see more of what you.offer here so you're looking forward to.that Thanks.[Music].so over here this is the Metroplex.adjacent to the hospital what we pretty.much do at the Metroplex surgical center.is most of our interventional procedures.are image guided injections different.techniques that we've learned over the.years to help relieve pain three.non-medicinal routes over here the.patients would come and just going to go.through a general intake they'll have a.seat on one of these recliners they.could even watch them TV if they like.while they're waiting but we pretty much.go through their little bit of their.history and physical again check their.allergies things like that set of an IV.if we need to and then once they're.ready once they're consented for the.procedure we then bring them back to the.procedure suite which is this way so.this is one of our procedure rooms as.you can see it has a big machine behind.me this machine is actually our x-ray.device it looks like a C but what it.does is allows us to see inside of a.patient essentially though be patient.we'll be lying on this table and we can.have an x-ray view of either their their.neck their lower back their mid-back.even joints even their hip joints and.with that information we can actually.guide a needle very carefully and.precisely to a specific points and do.some of these more precise precise nerve.blocks or joint blocks after the.procedure is done myself and the nursing.staff that will be in this room will.help clean up clean up the patient tidy.up the room and then we take the patient.and we bring them over to the recovery.area.and so this is the recovery room after.the patient is done with their procedure.they come to this room and we guide them.into one of our cubbies back here have.them have them take a seat on one of.these recliners where they can watch TV.they can have refreshments coffee.cookies that sort of thing but mainly we.bring them here and we assess them for.their pain relief in addition to that we.answer all of the questions that they.may have and we also set them up with a.follow-up visit so after the patient is.done with their their procedure here.which all takes place them the same day.we then we then have them go home and we.see them within a week or two for a.follow-up to see how they're doing.so I'm here with dr. Craig Van Dien and.he's going to tell you a little bit.about what he does with ultrasound in.this space thank you very much so I am a.sports medicine specialist and also I.have a primary specialty of physical.medicine and rehabilitation as part of.my training I learned interventional.diagnostic ultrasound this is really.part of the continuum here at the Center.for sports inspired medicine because.what we can really do is offer patients.different procedures to help target.areas of pain so I use the ultrasound as.a tool one to diagnose to find out why.they're having pain is it osteoarthritis.is it tearing of a tendon is that.tearing a ligament is an inflammation.and then I can target that directly with.the needle we tend to see very good.outcomes with this because the.ultrasound allows us to get a needle.directly to that area and then inject.medications to that region whether it's.a steroid or whether it's some of the.newer techniques like regenerative.techniques such as Prolotherapy or PRP.wow that's amazing so you can take a.look right on this ultrasound mystical.machine and most of the time see what.could be the issue for the patient.exactly so the patient comes in to me.and tells me they have knee pain what.I'll do is I'll bring this ultrasound.out for our encounter I'll take a look.at the tissue I'll see whether or not.there's bony irregularity I'll see.whether or not there's fluid I'll take a.look at the straw.almani and that will allow us to target.of what i think the pain is coming from.of course every time we do this this is.really a secondary approach to the.primary means of management which is.physical activity and exercise but if.they're not responding this gives us a.tool to actually go in and try to.control the symptoms and then improve.outcomes at the end and you can be much.more precise if there is any medicine or.anything that needs to be injected into.that exactly so this is all about.precision and improving accuracy and we.know that with ultrasound the accuracies.far greater than than some of the more.traditional techniques sure so would.this be the first step in someone coming.or would this be a secondary step to the.first part of the reason sure so if a.patient comes in it depends on really.what they're feeling at the time the.level of the pain is so severe and it's.not controlled by medication and hasn't.been controlled by any of their prior.management we may consider this as a.first-line if we can get the pain under.controlled and the outcomes tend to be.better over the course of exercise and.physical therapy and things of that.nature.if their pain is moderate and maybe not.that severe then we may try exercise.first and then if that doesn't work we.may consider this to get the pain under.better control and then go ahead and.reinstitute the exercise program okay.wonderful so it's always pretty much a.multi-faceted approach it's just which.one you're going to target for a second.or third exactly and everything we do is.in the best interests of the patients so.there are many different options and.many different things that we can inject.the control symptoms based off of what.the pathology actually is so we make.sure that every patient comes in as an.individualized care plan and that what.we do is in the best interest in the.patient and the goal is to restore.function and get them.- doing therefore these activities sure.so is it always medication or do to do.PRP as well so we also do PRP so PRP as.platelet-rich plasma basically we're.using the patient's own blood we're.harvesting a component of that blood and.it basically allows I would say it.augments healing for that patient so for.certain conditions we know that it works.very well both than pain control and in.some instances tissue regeneration so we.do do that as well as part of our.treatment plus wonderful because it's.actually a wellness situation they're.not injecting any medicine but their own.body is healing itself right exactly and.that's the ultimate goal so it's still.in its infantile stages in terms of.research but as time goes on we're.learning more and more about the.capacity to regenerate and self heal and.we're hoping to reach the point where we.can really make a huge indication on a.lot of these problems that haven't been.able to be treated effectively before.with conservative techniques excellent I.mean it's amazing you know what the body.can do so it's I know you're going to.show us also a video of how you actually.target that pain and you're able to see.and help the client right through -.exactly so what I'll do is I'll have a.video that I will show you and basically.we're going to use a target which is.just a circle it's used off of a model.and we're going to approach that with.the needle and the idea is to show you.how the needle can approach that target.we can effectively get medication to the.region.that's our goal in terms of management.so doc show me a little bit about your.equipment and how you actually target.sure absolutely so let me talk a little.bit about the device the nice thing.about ultrasound is that unlike x-ray.cat scan there's no radiation exposure.so for patients who come in and get.analyzed with the ultrasound they don't.have to worry about any side-effects.from the machine itself so the way that.it works is we have this probe probe has.crystals inside of it what happens is as.the electric signal comes into the probe.the crystal vibrate it sends a sound.wave into the tissue and then based off.of the type of tissue that is coming.contact with that will determine how.many sound waves bounce back how many.get absorbed how many bounce off in.another direction and it determines or.comes up as an image on the screen that.I can interpret so different tissues.will have different properties so what.we use as a medium to to transmit the.waves is actually a gel and what I'd.like to do is show you a demonstration.on your arm so that way we can see the.different tissues and you get a better.idea in terms of what I'm talking about.okay so I'm just going to place the.probe on your arm and you will feel.anything so while we can see when I look.at your arm and I'm going to change this.to kind of improve the image quality you.can see that there's varying degrees of.tissue here so what we see is we see.this sharp border down here which would.be suggestive of bone we see softer.tissues here which is more suggestive of.muscle and I can actually track things.up and down so I can follow tissues up.and down particularly at the course of.nerves of the course of muscles the.course of tendons and it gives me a.better idea and really live feedback.about what's going on so that way when a.patient comes in I can put this together.with the symptoms that they're having.and really determine what the best means.of management is for them wonderful.great I don't know if I would know what.that all looked like but I'm sure you do.yeah so it takes a keen eye takes a lot.of practice but really anyone can learn.it so what I like to do in the patients.come in is as I'm doing the.demonstration or as I'm getting the.images I will actually point things out.so that things are more clear and you.have a better understanding of what's.going on wonderful are you going to show.us how you target the actual situation.with the needle as well sure absolutely.so I do have an image with the needle.and basically we have a circular target.that shows how we actually come towards.a target so if you watch the screen you.can see that there's a circular target.here which is where I'm going to be.pushing my needle towards so you can see.the needle coming across and I can.actually guide it directly to that.target the nice thing is that I can.visualize the needle I can make sure I'm.not hitting other tissues nerves blood.vessels and then I can implant or put.the medication in the region that it.needs.that's perfect I would say if I had a.needle going and I would want you to be.looking at it at the same time oh I.think that makes a lot of sense and I.think it makes patients a lot more.comfortable and I can use much smaller.needles so I think overall it's a much.more pleasant experience for patients.who do have to end up getting a.procedure Wow.so that has evolved over the years I.definitely and the technology is getting.better and better we're seeing more and.more both from diagnostic standpoint and.it's helping us significantly with the.interventions it's amazing.thanks so much doc no problem I really.appreciate it.I'm excited to be here with dr. Laura.Dale fo and he's going to explain what.his specialty is here at the JFK.Rehabilitation Center hi doc hey and.thanks so much for visiting us today so.I am interventional pain specialist here.at the Center for sports it's my.medicine ed jacket RI and I specialize.in exactly that in intervening for.patients who have any myriad of issues.that cause them pain so whether that's.something as simple as a muscle injury a.tendon injury or things that might be a.little more complicated like evolving.the back of the spine you name it we can.offer solutions that kind of fold into.everything else that we offer here it.sounds like it's a very multi-faceted.approach everybody that you're dealing.with here it seems to take the patient.as a whole and then solve the problem.between all three of you which i think.is such a benefit absolutely that's.absolutely right.we have a very collaborative approach in.our clinic so are other physicians who.you've met with often times we're in the.clinic together we get to see our.patients together we all offer our own.expertise in treating any patient issue.and once again you know that also.extends to all of our wonderful.wonderful physical therapy staff our.occupational therapy staff all of our.adjunctive treatment set that we have.here at JFK wonderful so you'll be.seeing patients prior to surgery and.also post-surgery as well that's right.so I'm trained in physical medicine.rehabilitation and as you may have heard.dr. phreak mentioned before our approach.is really a non-surgical one from the.get-go so we are trying to.help in any way that we can restore.patient's function without having to go.to that surgical step well of course as.part of our continuum we are involved.with and you know intimately.collaborating with surgeons when that.may be necessary and oftentimes if.people do end up having surgery we can.also help them with issues that they.have down the road so it's a constantly.evolving process and treatment plan so.you are based right here but also.there's another area that we're going to.be looking at as well where you do a lot.of your specific work right that's right.all of our fluoroscopic Allah guided.interventional procedures which is just.a fancy way of saying x-ray guided are.done across the street at the same day.surgery center our meta Plex and that's.a place that is very useful for us.because we have specialized equipment.that we can use to target our therapies.very safely and our patients won't.provide them with the best possible.treatment the campus is very vast very.busy and you're also knowledgeable it's.been so great to be here today to be.able to really tour the facility and see.how the specialty I'm so glad to be good.show you everything we have so thank you.again for joining us today this has been.a great show right here at JFK.Rehabilitation Institute we're so happy.to have you with us.and we look forward to seeing you again.on wellness Woodbridge good bye.[Applause].[Music].

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Nj Certificate Rehabilitation Form FAQs

Check the below common queries about Nj Certificate Rehabilitation Form . Communicate with directly if you still have other queries.

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How do I fill out the IT-2104 form if I live in NJ?

Do you work only in NY? Married? Kids? If your w-2 shows NY state withholding on your taxes, fill out a non-resident NY tax return which is fairly simple. If it doesn't, you don't fill out NY at all. If it shows out NYC withholding you enter that as well on the same forms. Then you would fill out your NJ returns as well with any withholding for NJ. Make sure to put any taxes paid to other states on your reciprocal states (nj paid, on NY return and vice versa)

Where can I get the form for migration certificate?

If you are under CBSE board then go to CBSE regional office near you and ask for migration form and fill it then submit to cash counter (Less then 500rs). Same thing with Others

How long does it take to get a certificate of rehabilitation?

Data scientists are big data wranglers. They take an enormous mass of messy data points (unstructured and structured) and use their formidable skills in math, statistics and programming to clean, massage and organize them. Then they apply all their analytic powers – industry knowledge, contextual understanding, skepticism of existing assumptions – to uncover hidden solutions to business challenges. “A data scientist is someone who is better at statistics than any software engineer and better at software engineering than any statistician.” On any given day, a data scientist may be required to: Con Continue Reading

How do I get a pardon in NJ?

If you are an employee it will be on your W-2 form. (or, in some cases, on your w-4 form.) If you are self employed or a business, it will be on the tax documents you got to enable youth make your quarterly payments. If you don’t have it in either of these places your are probably in trouble.

How long does it take to get a certificate of relief?

I have applied for the german work permit recently. You need to submit all documents according to their websites. ZAV approval letter is very important if it is applicable for your case. It will speed up your process and make sure that there is no mistake in your draft. Don’t go SBI for Draft. In my case, I had the ZAV approval. I gave the intervierw on 03.03.2020 and I got the visa on 04.03.2020 (Within 24 hours) and collected on 05.03.2020. Best of luck!!!

How do you get a pardon in California?

Most likely. He was one of Trump’s earliest and most rabid supporters, so Trump will pay him back by pardoning him, and also as a message to other Republican politicians: keep supporting me and whatever federal crimes you’ve committed, I’ll get you out of.

How long do you have to wait to get a felony expunged in California?

if you’ve already been convicted of a felony, there’s no altering it, but you can still get it expunged, if you’ve been out of prison and off paper for several years, if it was non-violent, if you can pay the needed attorney, and if you have only one conviction. It will be a lot easier to get all your rights restored if you move to AZ, tho.

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