Three-year-old Toria was having a bit of fun at Phoenix Children's Hospital. She'd decided to test the limits of the electric hospital bed, contorting it into odd shapes. Then - this was the really fun part - she'd call for the nurses to rescue her.
Such hijinks were not what Toria's parents, Jim and Patti Karas, expected from their daughter - not just because she'd never been an especially smiley, social toddler, but because she'd just had an operation that required an incision spanning nearly the entire width of her abdomen.
They were in the midst of a roller-coaster ride that had started less than a week earlier. The family had just moved to the Valley from Massachusetts when Toria starting complaining of a stomach ache, then developed a fever.
Blood tests showed an abnormality in Toria's white blood cell count. Since appendicitis is a significant risk in young children, and the pain was in the area of the appendix, the physician recommended an immediate appendectomy. She was taken into surgery at a Valley hospital, at midnight.
But after several days in the hospital, Toria continued to have a high fever, even with intravenous antibiotics. Toria's doctor ordered an ultrasound of her abdomen, which appeared to show a swollen spleen with an abscess on it. The doctor recommended that she be transported to Phoenix Children's Hospital immediately, where specialists could confirm the diagnosis and remove the spleen if necessary.
When she arrived at PCH, infectious disease doctors were waiting, and a CAT scan was done to get a clearer picture of the problem. Prepared for another possible surgery or even lifelong medication, Toria's parents were not prepared for a different diagnosis altogether.
A pediatric oncologist explained that Toria had a cancerous tumor on her left kidney. The large object on the ultrasound was not her spleen, but a large tumor. The abscess was identified as the remainder of her left kidney. She needed surgery immediately.
"I can't say I ever had the chance to really panic," said Patti, "because the doctor was so good at reassuring us. He explained that a Wilm's Tumor, especially if caught early, has a high rate of cure."
Toria had the tumor, along with her left kidney, removed. Because the tumor had spread to some lymph nodes, Toria would need both radiation and chemotherapy, but the prognosis was good.
By this time, Patti's mother had arrived to help care for Toria's 7-year-old brother, Tyler. The Karases sat the two children down together to explain what had happened. Over the next few months, Tyler would become Toria's "white knight" shielding her from others on the playground and holding her hand wherever they went.
But the most unexpected change was in Toria herself. While recuperating in the hospital, Toria quickly became known for a certain impish quality. She had a couple of favorite nurses, and they were "favored" mercilessly with urgent calls from Toria's bedside buzzer. They would arrive to find Toria feigning sleep. Her more playful demeanor caused her mom to wonder how long the tumor had been causing discomfort.
The radiation treatments started soon after Toria's discharge from the hospital. After two weeks of radiation, she began seven months of chemotherapy at the Children's Cancer Center at PCH.
The toughest part of the treatment for Toria's parents was watching their daughter "shrink" before their eyes. She'd entered the hospital at 39 lbs.; at the height of her treatment, she weighed just 23 lbs. "It was such a relief when she began eating again," Patti said. "Now she often has three breakfasts. I guess she's making up for lost time."
Patti can't say enough about the care at PCH. She moved here from an area where most of the children's hospitals were established before Arizona was even a state, and confessed, "I guess I was a bit of an East Coast snob. Now, I tell everyone this is the best hospital. The doctors were never too busy to call back; the nurses were never too busy to stop in."
The Karases are still involved with the hospital's cancer support group, Rainbow Kids.
"We want to be there for other families, to help them through and share what we've learned," Patti said.