By Kevin Finch

Standing on a chair in his grandmother’s kitchen, Duane Sunwold started cooking at age four and never stopped. By the 4th grade, flour streaks matched the grass stains on his pants as he mastered the mysteries of a pie crust and never looked back.

Duane is a chef, instructor and department chair for the Inland Northwest Culinary Academy at Spokane Community College (SCC) in Washington State. The Culinary Academy where he now serves as chair is also where he first picked up his professional chef credentials in the 1970s, before heading north to Canada for additional training. After working as a Sous Chef in northern Idaho, he took only two years to advance from waiter to assistant general manager at a resort in Hawaii.

In 1982, he returned to SCC to teach, and has led the Culinary Arts department for 12 of the last 16 years. The four year gap in his time of service is significant.

In the fall of 1999, he told his colleagues in the department that he could no longer serve as chair. Even with the rest of summer behind him, he felt completely exhausted. In hind sight, he realized this deep tiredness had been building for several years, but in 1999 he could no longer ignore it. It was all he could do to survive his own teaching load, and by Friday each week he looked like a walking cadaver.

He survived the school year only to wake up on his 43rd birthday with further inexplicable symptoms: a massive migraine and the right half of his face suddenly swollen to "Elephant Man" proportions. Numerous doctor visits during the summer and fall of 2000 failed to turn up any cause for the headaches, swelling or his on-going exhaustion.

This changed only in December when a physician’s assistant ordered another complete blood and urine work-up and caught something previously missed. Duane’s kidneys were spilling the protein albumin like a punctured plane leaking fuel. Typically a person might lose only 50 milligrams in their urine a day. Duane was losing 240 times that: 12 grams. Describing the situation with a rueful smile he says, "I was literally peeing egg whites" (which are composed of the protein albumin).

A week later doctors admitted him to Sacred Heart Hospital with dangerously high blood pressure and a Teflon migraine that nothing but a morphine drip could touch. The diagnosis? Chronic kidney disease (CKD). The prospects? Grim.

CKD is measured in stages. Problems begin at stage one; stage five is organ shutdown and dialysis or transplant. In just months and despite massive doses of steroids and other medicines, Duane had a creatinine, a measure of how well the kidneys function, of 4.7. "I could FEEL dialysis," he says.

Desperate to talk to any doctor who might offer some hope, 18 months after his initial diagnosis, he sat down in the office of Dr. Katherine Tuttle from the Providence Medical Research Center at Sacred Heart. Since Duane was not her patient at the time, she remained circumspect. Yet in addition to suggesting several medication adjustments, Dr. Tuttle also mentioned that animal protein was particularly hard on struggling kidneys.

For someone whose livelihood is in the kitchen, this passing comment stuck. None of the other doctors Duane had seen to this point had mentioned diet, but after Dr. Tuttle did, Duane passed it along to Erin Clason, the registered dietitian on the SCC faculty.

Clason knew how rapidly Duane was declining. Months before she had requested copies of his lab test. After a few days to think over Tuttle’s comment, Clason dropped by Duane’s office on a Friday to propose a 90- day experiment. She wanted him on a vegan diet that cut out the hard-to-process animal proteins.

For a man on massive steroids who was constantly craving cheeseburgers, this sounded almost impossible, but Erin wisely proposed he not start until after the weekend. "Eat whatever you want for the next two days," she said.

Duane finally agreed and went home and promptly ordered four large pepperoni pizzas with extra cheese. With the help of his family he plowed through all four like a man eating his last pizzas.

As wonderful as they tasted, the meat and cheese on those pizzas made Duane very sick. He spent the rest of the weekend in bed unable to eat another thing, and when he crawled into the office on Monday he was desperate enough to do anything for 90 days.

It only took 14 days before Duane realized they might be onto something huge. After only two weeks on a vegan diet, he felt better than he’d felt for a year and a half of heavy drug treatment for his kidney disease. Remarkably, his lab work confirmed his experience. He didn’t just feel better, he was better.

The change bordered on miraculous, but an easy miracle it wasn’t. Forty years of eating habits for someone who adores food doesn’t change because four pizzas one weekend make you sick. Still on steroids that made him crave meat, Duane remembers a day he went shopping with his father. As lunch approached, he begged his dad to pull into the drive-through of any one of the fast food restaurants running the length of the street they were on. When his father refused,

Duane rolled down his window and hung out his head to at least smell the meat cooking as they drove by.

Tuttle says it can be hard to convince CKD patients to change their diet. "They would rather take a pill." Duane agrees. At first he worked only to cut out animal protein, but in time he realized he needed to also avoid salt and saturated fats. Sugar also surfaced as an issue because he had been diagnosed as a borderline diabetic.

"Not everyday is a home run," he says, but as a chef he has approached this as a cooking challenge rather than a career crisis. Rather than just grieve about what he needed to cut out of his diet, he threw his energy into creating great recipes with the very foods that helped save his life.

"Anyone can use a saltshaker," he says. "Now I have to ask, how do I extract flavor without salt?" Overcoming this challenge has made him a better cook, and has put him on the cutting edge of creative cuisine for those with CKD as well as people with diabetes, high blood pressure and heart disease. Onions and garlic have become his fast friends in the kitchen and with a grin he adds, "It is always better to have bad breath and good lab results."