With pudgy cheeks, her red hair in a waterfall pony tail, decked out in pink from head to shoes, it's hard to imagine the Sarah Cole Hardy from a year ago, the one facing a grim prognosis.

"Miss Sarah Cole Sparkles!" an MUSC nurse says, grinning. "You're so pretty in your pink dress."

Sarah Cole toddles toward the nurse's voice, clutching a purple plastic spoon in one hand, a zebra blanket in the other, and grins widely.

The nurse hugs her. "I love seeing you," she says.

Sarah Cole, who turned 3 on Palm Sunday, hugs her back.

Last year, the little girl spent her second birthday in the hospital. Her mother, Cassy Hardy, struggles to remember it. She thinks they had a lady bug birthday some time between hospital admissions.

It's hard to remember specifics through the fog of fear.

But last weekend, the Walterboro family gathered at Sarah Cole's great-grandparents' property for a pink cowgirl birthday party to end all cowgirl birthdays.

They had pony rides, marshmallow guns, panning for gold, cake, you name it.

After all, her once dire prognosis today is full of hope.

Losing hope

At first, Sarah Cole seemed like any healthy, happy baby. But after she celebrated her first birthday, she wouldn't eat much.

She began to lose weight. At times, her eyes looked strange, as if they were vibrating.

At 19 months, she suddenly could barely stand or walk. Her pediatrician sent her straight to MUSC.

In November 2012, an MRI showed why.

A large tumor grew in the center of little Sarah Cole's brain. An enemy likely born while she was still in the womb, the large tumor was destroying her sight and threatening her life.

Shortly after that Thanksgiving, Sarah Cole underwent major brain surgery. Surgeons removed 60 percent of the large mass, although they couldn't save her sight.

Still, they thought -and hoped - the tumor might be benign.

'New normal'

Sarah Cole suffered a seizure in the hospital around the time her biopsy came back.

The girl's close-knit family sat down with Dr. Amy-Lee Bredlau, director of MUSC's Pediatric Brain Tumor Program.

The toddler had a childhood cancer called pilomyxoid astrocytoma. A very rare tumor, diagnosed in fewer than 50 children a year, these tend to be aggressive, Bredlau says.

Cassy grew up in Walterboro. It's a small hometown where cousins are like siblings and neighbors considered family. With the devastating news, Cassy went to the waiting room where many of them sat and broke the news.

"I told them this was our new normal," Cassy recalls. "It's perfectly fine to fall apart - but not in front of Sarah Cole."

And anyone who wasn't going to be positive about Sarah Cole's future wasn't invited on the journey.

They all prayed.

"From Day One, we gave it to Him," says Sarah Cole's grandma, Becky Hill. "And He carried all of us."

Much of the family is Baptist and some Methodist, but in a small town, especially when crisis hits, a prayer is a prayer and everyone joins in.

As soon as people heard about Sarah Cole's cancer, it seemed every church in Colleton County was praying for her. People told friends who told family who told friends, and soon churches all across South Carolina put the little redhead on their prayer lists.

"This is when you find out what your community is made of," Hill says.

One day, Cassy asked to see her baby girl's scans. Maybe the tumor wasn't as big, as terrifying as she imagined.

She tears up at the memory. "It was big."

In fact, the bright white mass was the size of a tennis ball.

Tumor grows

Sarah Cole began chemotherapy. She suffered seizures and went in and out of the hospital. But through the ordeal, their family and community rallied to help, to pray, to help carry a burden none could imagine.

After one hospital stay about a year ago, she went home but continued to do poorly. Her mom was getting her dressed to take her to their local hospital.

That's when Sarah Cole suffered the 13-minute seizure. Her big sister, Steelee, who's in kindergarten, helped her mom summon paramedics and tend to her little sister.

Paramedics rushed Sarah Cole to the hospital. From there, she was flown by helicopter to MUSC.

A new scan showed the tumor continued its aggressive march, still growing, its mass whiter, bigger, more alive.

Her doctors took her off the chemotherapy.

With few options, hope for her future appeared dim.

Cassy pulls out a photo from last year. Sarah Cole stares at the camera, gaunt, sallow, like a child barely there, barely alive.

New dawn

It wasn't an easy decision. Every new therapy is terrifying for families as they hear of new devastating side effects, no matter how small the risk.

Bredlau laid out the options, including a new chemotherapy.

Her family summoned the courage to try it.

"She has done beautifully under this second therapy," Bredlau says. The tumor has shrunk to about half of its post-surgery size. Aside from getting tired, she's suffered no big side effects.

Sarah Cole will continue the therapy "until it has shrunk so small we don't think it will shrink any more," Bredlau says.

Just as promising, Sarah Cole shows no need for radiation. At the toddler's sickest point, Bredlau worried it might become necessary.

"That is really scary for someone as young as Sarah Cole," Bredlau says.

Radiating such young brains typically causes severe, lifelong disabilities.

"We might be able to successfully treat her without radiating, which is fabulous," Bredlau says. "We're very happy with how she's progressing."

Sarah Cole could even be cured one day.

Giving life

At MUSC one recent day, Sarah Cole scowls when she hears a baby cry from a nearby exam room.

"That baby's got to get chemo, too," her grandma explains.

"Why?" Sarah Cole asks.

"It's just what you have to do."

This seems to make sense. She continues to explore her own room while awaiting chemotherapy.

She's blind, but that isn't readily obvious to strangers. It's seemingly not obvious to her either.

She toddles around, feeling her surroundings, keen to voices, trying out new words on her mom and grandma. She eats snacks, climbs on a chair.

She loves sparkles.

Bredlau says that may indicate she can decipher some light and dark. Whether she will regain any vision remains unknown.

"God took her vision, but he gave her life," Cassy says, wearing a hot pink Team Sarah Cole T-shirt. "In the past year, we've had a lot - a lot - of success."

She pulls out her iPad to show the toddler's earlier MRI scans, the ones that showed the large bright mass. She scrolls to the newest scan. The tumor isn't as white and is perhaps half as big.

"Now is when we can put our thoughts together and say, 'thank you,' " Hill says.

Cassy nods and wipes away tears of gratitude. "We want to show them what their prayers have done," she adds.

After all, at the Children's Hospital they have seen children dying. They have seen their parents and siblings in agony.

"We thank the Lord for our problems," Hill says. "You take the rain and appreciate it."

After celebrating Easter, Sarah Cole starts school Monday at a public school in Colleton County where she will work with a variety of therapists.

"She excited to learn, and they're excited to teach her," Cassy says.

Cassy admits separation anxiety creeps into her thoughts. But she and her family have known Sarah Cole's teacher for years.

It's yet another perk of living in - and being loved by - a small town.

Reach Jennifer Hawes at 937-5563, follow her on Twitter at @JenBerryHawes or subscribe to her at facebook.com/jennifer.b.hawes.