Innovative vein treatment ends decades of suffering

Posted January 18, 2018 2:00 p.m. EST

WEST PALM BEACH, Fla. -- For most vein-disease sufferers, symptoms are intially subtle and appear gradually.

Such, unfortunately, was not the case for Keith Bolster.

"I first started suffering from painful open leg sores when I was a teenager," says the 43-year-old restaurant server and Davie, Florida, resident.

Bolster's vulnerability to these outbreaks stems from childhood kidney cancer.

As a toddler, he was diagnosed with a Wilms tumor, which resulted in the removal of a kidney and the rerouting of several arteries.

The alterations to Bolster's arteries compromised his circulatory system, and once the sores started appearing during junior high school, they became a chronic reality.

"They'd never really fully close or heal," he recalls. "It was just a matter of how severe they'd be when they acted up."

By the time Bolster reached adulthood, the condition had become progressively worse. At their most severe, the sores would be a couple of inches in diameter and often penetrate deep into his leg.

"There were times when bone would be visible," he says. "Simply walking would feel like getting stabbed with a knife."

Bolster did his best to stay positive. He steadfastly refused to miss work shifts -- no matter how painful it was. In order to protect his legs while showering, he'd wrap them in plastic garbage bags.

"My attitude was, 'I'm in pain -- but so what? I still have to do what I have to do.'"

Bolster also searched far and wide for effective treatment.

"I've been to more wound care centers than I can remember," he says.

The treatment protocols were all short-term, topical fixes -- analgesics, creams, ointments, Unna boot compression dressings, etc.

It wasn't until he was referred to the David L. Smythe Wound Center in Stuart, Florida, in 2015 that he found doctors who took a different approach.

"At the Smythe Wound Center, they treated my sores similar to how they'd treat burn victims: by doing skin grafts."

This was a more effective technique for relieving pain -- but didn't address the issue of recurrence.

For that, the Smythe Wound Center doctors asked vascular and interventional radiologist Dr. Steven Tidwell, of Medicus Vein Care in Jupiter, Florida, to examine Bolster.

After administering ultrasound tests on both of Bolster's legs, Tidwell determined "Keith had significant underlying venous conditions that were most likely a result of his childhood cancer."

In other words, the untreated vein disease was causing chronic ulcerations (sores). Bolster's "venous insufficiency" was resulting in perpetual venous reflux -- and rather than it manifesting as varicose (enlarged) veins, he was suffering from excruciating open wounds.

"From the moment I met Dr. Tidwell, I felt totally comfortable with him," Bolster recalls. "And once he explained what was happening beneath the surface with my veins, and how he could treat it, I felt confident I'd found a real remedy."

Tidwell performed several in-office laser ablations on Bolster's legs.

With this minimally invasive procedure, Tidwell uses ultrasound guidance to insert a laser fiber into the precise area of the refluxing vein. The laser energy closes that vein permanently -- and blood flow is redirected to healthy veins. The procedure is performed under local anesthesia and typically lasts 30 to 60 minutes.

Bolster's ulcerations healed within six weeks of the final ablation and now he visits Tidwell periodically for "maintenance care." He couldn't be happier with how much his life has transformed.

"I can go in the ocean again. I can take my dog Cooper for long walks again."

And maybe best of all: "No more garbage bags when I shower."



Dr. Steven Tidwell, of Medicus Vein Care in Jupiter, Florida, notes that because vein disease "often mimics other conditions, typically it's not diagnosed in its earliest stages." He says, if left untreated, vein disease "always gets worse." Here are some of the early warning signs:

-- Achy legs.

-- Restless leg syndrome.

-- Throbbing sensation.

-- Fatigue.

-- Itching.

-- Tingling.

-- Heaviness.

Steve Dorfman writes for The Palm Beach Post. Email: sdorfman(at)

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