Stop Your Pain. Start Your Life. Regenerative Spine and Pain Regenerative Spine and Pain Institute Taking the Fight Against Chronic Pain to New Levels

Stop Your Pain. Start Your Life.

27 different therapies available to patients, Dr. Patel offers a range of treatments, often combined to attack highly specific causes of pain. Among the most promising and innovative treatments:

Botox for migraines. Stem cell injections to regenerate tissue and organs. Gummy Bears infused with THC. Platelet-Rich Plasma to treat conditions from sports injuries and wounds to hair loss from chemotherapy. These are just a few of the cutting-edge therapies used by Dr. Ronak Patel, the founder and medical director of Regenerative Spine and Pain Institute in Plainsboro.

“Many of these treatments may come as a surprise to patients suffering from chronic pain, especially those who think that their pain — and poor quality of life — is something they have to endure,” Dr. Patel notes. A double board-certified anesthesiologist and pain management specialist, Dr. Patel focuses on treating pain in the back, neck, face, and joints as well as pain related to cancer and chemotherapy.

27 different therapies available to patients, Dr. Patel offers a range of treatments, often combined to attack highly specific causes of pain. Among the most promising and innovative treatments:

Cannabis Therapy. The legalization of medical marijuana has brought new treatment options. “We are very excited by the potential of cannabis-based treatments and we comply fully with New Jersey’s evolving regulations,” says Dr. Patel. He uses a local dispensary to provide treatments, which include edibles such as gummy bears and cannabis-based rubbing and vaping oils.

With so many different pain-causing illnesses, injuries, and conditions, treatments must be carefully customized to fit the needs of each individual patient. Dr. Patel partners with orthopedists, physical and occupational therapists, and chiropractors to provide a variety of approaches and treatments. With

With so many different pain-causing illnesses, injuries, and conditions, treatments must be carefully customized to fit the needs of each individual patient. Dr. Patel partners

Regenerative Medicine/ Stem Cell Therapy. Regenerative medicine is a fastgrowing, highly developed treatment that helps the body heal or rebuild itself. Dr. Patel uses stem cell therapy to treat ailments, particularly low back or neck pain, caused by degenerative vertebral discs or joint pain in the shoulders, hips, or knees caused by osteoarthritis. The patient’s stem cells are removed, purified, concentrated, and injected into the injured or weakened tissue. Stem cell therapy can also speed recovery and help avoid surgery.

Regenerative Medicine/

Stem

Cell Therapy. Regenerative medicine is a fastgrowing, highly developed treatment that helps the body heal or rebuild itself. Dr. Patel uses stem cell therapy to treat ailments, particularly low back or neck pain, caused by degenerative vertebral discs or joint pain in the shoulders, hips, or knees caused by osteoarthritis. The patient’s stem cells are removed, purified, concentrated, and injected into the injured or weakened tissue. Stem cell therapy can also speed recovery and help avoid surgery.

Platelet-Rich Plasma (PRP). A favorite treatment for sports injuries, PRP uses the patient’s blood to produce a platelet-rich plasma that targets a host of chronic and acute pain conditions, including muscle strain, arthritis, tendinosis, cartilage injuries, joint inflammation, and wound care. The treatment is also used in orthopedic and plastic surgery. By synthesizing platelets and releasing proteins, PRP can aid in generating new tissue. And it has helped chemotherapy patients grow back hair faster and thicker.

Minimally Invasive Therapy. Dr. Patel offers a wide variety of minimally invasive therapies. These include epidural steroid injections, facet joint injections, radiofrequency ablation, and spinal cord stimulation for patients suffering from chronic neck and back pain stemming from herniated discs, degenerative disc disease, or spinal stenosis. His goal is to help his patients avoid surgery and at the same time regain functionality.

Thanks to these and other game-changing treatments, pain levels can be greatly reduced or eliminated and quality of life enhanced. Says Dr. Patel, “Stop your pain. Start your life.”

Communities of native plants support wildlife and pollinators, and while deer may still browse from them, as Wild Ones explained, mature plants can be “resilient” in the face of those pressures. Yet, if any invasive species present are not controlled, native plants risk being overtaken.

The Princeton designs primarily use perennials, or plants that return each year but may take longer to “get established,” as opposed to annuals, which only complete one growing season.

Snell is a certified arborist and founding partner of the Philadelphia-based TEND landscape architects, where her fellow designer, registered landscape architect Hanes, is also a founding principal. Hanes received her bachelor’s in landscape architecture from Purdue University, while Snell, who has a fine arts background, earned her master’s in landscape architecture from the University of Pennsylvania. Together, the women are the co-owners and operators of Redbud Native Plant Nursery in Media, Pennsylvania.

The designer statements for the singlefamily and multi-family properties share some of the same passages, but with details specific to each plan, as well as video interviews where Snell and Hanes spoke, respectively, about them with Wild Ones

To see the recommended phasing, priorities, practices, or download copies of the Princeton plan(s), visit Wild Ones’ website at nativegardendesigns.wildones.org. Ecoregions with designs ready for implementation include Boston, Chicago, Washington, D.C., and others.

Because the mid-Atlantic region has been inhabited since before the American Revolutionary War, these plans differ from previous Wild Ones designs in several ways. According to the Wild Ones Princeton template page, “land development patterns and housing types show this age, coupled with modern demands for density and ways of living that meet a wide range of population needs from university students to young families to the elderly.”

Wild Ones, which started in the Midwest, has three chapters in New Jersey: Gateway, Southern, and Skylands, the latter two of which are seedling groups still in the early stages of expanding membership and programming.

Skylands serves the northwest counties of Mercer, Morris, Somerset, Sussex, and Warren. Its president, Daina Gulbis, is a chemical engineer by trade and a certified master gardener for Somerset County, where she has resided since 2005. Gulbis currently works as the K-8 Garden Coordinator for the Somerset Hills School District and an environmental educator for the Raritan Headwaters Association.

After speaking with the president of the state’s Southern New Jersey group, Josh Loew, both Gulbis and Gisela Ferrer volunteered to start their own chapters in March of last year, with Ferrer now leading the state’s Northeastern Gateway chapter. Gulbis is thrilled to be able to share these Princeton templates as something tangible that can still be applied to many ecoregions and prove that raising native plants does not have to be “overwhelming.”

“I think that is the hardest part to figure out when you move to an area or when you decide you want to plant: what is it that’s going to be native, that can grow, that’s going to be flowering at this time, so that I can have a continuous flow in my garden? We have a lot of resources out there for Jersey, but it takes a lot of time,” she explained.

“Not everybody can afford to have a landscape architect come and take a look at their space,” Gulbis said, with the designs making that easier. She also expressed her love for “the tables at the end, because you can also pick and choose” from substitute plants that “all grow in this area and climate.”

Native plants featured include the bottlebrush buckeye, left, blue flag iris, upper right, and swamp milkweed, lower right.

Image credits, in order: Magnus Manske, Wikimedia Commons, and Ryan Hodnett.

Snell and McDonald both recommend planning and preparing the site in the summer, which may include cleaning up the property and removing invasive species, before planting native species in the early fall. This way, rather than forcing the gardener to be hypervigilant about watering in the summer to ensure the survival of the seedlings, they can do so in September, October, and/or November to give the roots a longer time to settle. This puts them ahead of schedule by spring and will result in heartier plants come summer.

Gulbis personally plants for different reasons in the fall and spring. She shared that because the beginning of autumn is the end of the traditional growing season, nurseries tend to sell plants at reduced prices.

The “plugs” for native species, a term for seedlings grown in trays with potting soil, are sold in spring and present gardeners with visible blooms. But as opposed to their previously planted counterparts, which will likely spend their first years as stems, these spring plants will require more attention and water, especially in hotter weather.

Gulbis says she does both—some for those visuals that signal the warmth of spring has arrived, and others for long-term planting that profits from patience.

Snell and Hanes advise that the process is best done in phases, proposing that people first define their goals for the landscape, such as what they want in the finished product—spots for growing produce, sitting, or playing—and evaluate their abilities to do the work required, such as coordinating with landscape professionals or budgeting. By establishing funding expectations and a timeline for incremental improvements or additions, the homeowner can devote the scheduling and monetary resources required to complete their vision, as well as all the maintenance that entails.

To help map out a balanced garden, the designers say it is important to document the following factors: sunlight, shade, and water flow patterns; conditions and/or types of soil, drainage, and moisture; as well as what plants are already growing

See Wild Ones, Page 6 in the space, both invasive and native. For more information on invasive species in the mid-Atlantic region, visit invasive.org/ eastern/midatlantic

In the designer statements, Snell and Hanes encourage homeowners to work closely with an arborist certified by the International Society of Arboriculture, or ISA, to identify keystone species, such as oak trees, which are organisms that the ecosystem cannot exist without.

But removing the hazards—large trees that are dead or damaged, areas negatively impacted by erosion and flooding, or the advancing encroachment of invasive species—is just as essential as thoroughly studying the site.

Hanes advised conducting at least one “soil test” to detect its nutrition and acidity before starting the garden, and since Princeton spans the transition from the inner Atlantic coastal plain to the ridge and valley ecoregion, several spots in the same yard can have differing compositions (clay, sandy, compacted, etc.).

For more information on how and where to properly submit soil for testing, Hanes suggested checking out the website for both the Rutgers New Jersey Agricultural Experiment Station’s Soil Testing Laboratory or Cornell University’s Soil

Health Laboratory

Climate change is also an undeniably big factor. According to Hanes and Hensey’s February YouTube discussion, the area averages around 47 inches of rainfall and 24 inches of snow annually, with increased but alarmingly unpredictable levels of precipitation and warmer temperatures expected throughout the year.

These seasonal fluctuations, according to Gulbis, are part of why a “random” April snowstorm can occur after a hotter summer and relatively “mild” winter. The Skylands president has witnessed vast changes in both the climate and what can successfully grow here—variables that were not present when she first moved to the state nearly two decades ago.

It is also worth it to be mindful of what the designers’ statements describe as “anthropogenic influences,” or “the age of density of development in an area” due to cycles of disturbance resulting from paving roads or storing building materials, which can increase the temperature in what is known as the “urban heat island effect.”

As explained in the “methodology” section of the single-family home template, following the designer’s site inventory and gathering of data, the objective was to restore ecological function and natural beauty, as well as empower residents to take advantage of the outdoors.

Visit local nurseries and sustainable suppliers, and keep a list of botanical names on hand when shopping or placing online orders. Wild Ones suggests purchasing native plants from Bountiful Gardens’ brick-and-mortar locations in Ewing, Lawrenceville, and Hillsborough, as well as Rare Find Nursery in Jackson, a mailorder retail plant nursery that operates by appointment only

The first priority is to manage the invasive plants and restore the woodlands, as the edge of the latter is what Snell deems the most “critical piece from the point of view of the homeowner” of a single-family property. In the designated woodland transition zone of the layout, she recommended planting flowering dogwood, fringetree, and other “large scale shrubs” like bottlebrush buckeye or Virginia sweetspire, which “hold the space really well.”

For the single-family property, Wild Ones advised reducing parts of the lawn to form a wide riparian buffer along the sides of a stream or the edge of a pond, then stabilizing that border by repopulating it with shrubs and herbaceous plants of differing heights. Snell said that what defines these houses in the “rolling hills” are having two sides of road frontage with a densely wooded upper east area that may be fragmented. The understory here is prone to damage from grazing deer, who gravitate to oak trees and can be kept out via a specialized fence or by adding species that tend to be more “resistant.”

The ideal space for the single-family property should have focal points and access to water features, Snell added, with the south side typically flanking what she described as a small stream lacking a definitive edge or vegetation, which has made the excessively mowed area lack stability and be more susceptible to erosion or drainage issues. Reinforcing these slopes with native plants can slow down the water to abate that.

These can include what Snell calls a pattern of “beautiful blooms” featuring swamp milkweed, fox sedge, different iris (crested and blue flag), soft rush, and ironweed. For a ranking and breakdown of what plants would fare well in this area, visit the Rutgers New Jersey Agricultural Experiment Station’s “Landscape Plants Rated by Deer Resistance” at njaes.rutgers.edu/ deer-resistant-plants.

By alternating areas of higher and lower vegetation, as well as creating “access points” to the water via stepping stones, a gardener can help mitigate flooding, restore the streambank and develop “a habitat zone of ground layer herbaceous and woody [plants] where there was none,” Snell explained.

Trees, especially ones in the canopy, provide structure, with the last point in the designer’s statement adding that once the spaces for sitting or other activities are placed, homeowners can use an organic site preparation method like solarization to eliminate the undesirable parts of the lawn that remain.

What the multi-family template loses in the townhouse style’s “postage-stamp front area,” it gains with a considerably bigger backyard, which can also be joined by a side yard and additional parking off the street. This front area would be drier and receive more sunlight juxtaposed against the backyard’s cooler, shadier temperatures, with the latter able to contain personalized zones for activities such as entertaining and growing a vegetable garden.

Both groundcover and mulching should be prioritized, but the easiest first step in this template, according to the phasing guide, is installing rain barrels to capture water and runoff from the roof downspouts.

The designer’s statement advocates for “lasagne gardening,” also known as sheet mulching, or smothering the grass with newspaper or cardboard and 4” to 5” of wood chips at least two months before planting to remove unwanted lawn. Hanes explained that this is an option for a less physical, but more time-oriented process.

When the season starts, any plants with exposed soil that have yet to mature should be covered with green mulch, what Hanes termed “a living plant,” which reduces the need for water and weeding even more than bark mulch or shredded leaves.

The multi-family home design calls for “as little pavement as possible,” since its prevalence cuts into what is already a scarce outdoor space offering little biodiversity outside of turf grass and invasive species. Hanes suggested using wood chips or mulch when laying out pathways or seating areas until another, more permanent solution can be installed. She also emphasized the value of putting doorway trellises in place to offer shade and be an “easily plantable, fast-growing upgrade.”

In Hanes’s Wild Ones presentation, she said to water plants regularly until established, a period of time which will take roughly one to two years for herbaceous perennials and two to three years for woody plants—but to resume, then increase the amount, in drought conditions.

Lacking a green thumb or the gusto to get your hands dirty? No need to worry; Hanes offered her own experience as an option, explaining that she plants native species in containers and shares that there might be local opportunities for verge planting, a style of community gardening for growing more biodiverse greenery in the “verge,” or boulevard, of a street.

Another example from Gulbis is that she

Stop Your Pain. Start Your Life. Regenerative Spine and Pain Regenerative Spine and Pain Institute Taking the Fight Against Chronic Pain to New Levels

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