Chilled Lemon Cake by Susan from Missouri

A Missouri grandmother’s cake recipe, lovingly recalled from memory, is a dessert few can resist. Susan, a DaVita renal dietitian, recalls good times with her grandmother in the kitchen as well as the ingredients and preparation for Chilled Lemon Cake, just the way grandma used to bake it.

The simple acts of taking care of people inspired Susan to become a dietitian. “I decided on dietetics due to my love of health care, taking care of people and the fascination of how diet can directly affect the outcome of an individual’s overall health,” she says.

Getting into the renal field was another story. “I was thrown into the fire, so to speak. I initially was resistant to the renal field, intimidated by the complexities of the entire dialysis process and the chronic nature of kidney disease in general. A very intuitive supervisor assured me I would find the renal field challenging and very rewarding, and I jumped in with both feet,” recalls Susan.

That supervisor was absolutely right, Susan does find the renal field challenging and rewarding. “The most challenging aspect of my job is finding new and innovative ways to help someone who is resistant to change, or fearful of the entire renal diet. The most rewarding aspect is seeing a patient who is vibrant, enjoying life and genuinely appreciative of the dialysis process,” says Susan.

Another aspect of her job that Susan enjoys is creating relationships with her dialysis patients. She appreciates, “the trust they put into our relationship that I will help them be successful with the entire dialysis process.”

Susan’s personal experience with her father made her more aware of the impact she has on her patients. She begins, “Working in the renal field for over 16 years, when relating stories about my job or experiences, my parents always said they would not be able to do dialysis or follow the diet. Unfortunately, my father ended up on dialysis the last year of his life; never really knowing what truly caused his kidney disease. I was delighted when my mother called to tell me they had met their dietitian (my dad dialyzed at another dialysis clinic in another city). Their dietitian was someone I had trained in renal during her dietetic internship a couple of years prior. My parents truly liked working with Kim, they trusted her to the point — that if I made a suggestion about something related to my father’s dialysis or diet — they would not act upon it until they asked Kim. Although this initially hurt my feelings, I had enough trust in Kim to know she would give them good, sound advice, and I was never disappointed. My father has since passed (from liver cancer); however, I am delighted to report that his renal dietitian, Kim, is now a valued peer within the DaVita family.”

Susan likes to use a positive approach when teaching her patients about the dialysis diet. “I teach about everything you can have and do with the dialysis diet, and not from what has to be limited or eliminated. I think this approach is much more effective and does not dwell on what some clients perceive as a negative with the renal diet,” explains Susan, adding, “I tell clients ’We don’t fix what is not broken,’ explaining that every person is different and the diet will be presented and followed up individually to each person. If labs look good, dialysis is successful and they are feeling well, then we continue as is with the diet. When lab results are out of range, or the patient is experiencing problems eating or eliminating, I treat the patient as an individual, going over their problems, diet, medications and lifestyle, and help them create a plan to solve their current problem.”

In addition to coaching, Susan likes to try new ways to educate her dialysis patients. “Taste-testing of renal-friendly recipes in our waiting room for clients and their families to try before or after their dialysis treatments is effective. This is good interaction of staff and clients, sharing of information and experience and usually a lot of fun for all involved,” she says.

You may want to have some fun in the kitchen and taste-test Susan’s Chilled Lemon Cake recipe. It’s easy to make and is a refreshing treat for potlucks, picnics or dessert after a renal-friendly meal.


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