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In 2000, Cara Cruz's life changed drastically when she fell on her leg and caused a blockage of lymph fluid. She went on to spend almost a decade working with doctors to understand her condition and in 2010, she learned that she had both lymphedema and lipodema—conditions which have both physical and sociological impacts on her everyday life. And for Cruz, getting tattooed and healing her ink is hugely impacted by her conditions. We sat down with the self-proclaimed #lymphedemawarrior to learn her tattoo story and what advice she has to offer to others with these conditions who want to get tattooed in the future.

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How did your journey with lipedema and lymphedema begin?

In 2000, I was a senior in high school when I fell and injured my left leg. I was convinced that I had broken my leg. It turned out that I cracked tissue and damaged a lymph channel. This resulted in a quarter size lump appearing on the front of my left leg, right above my ankle. If I massaged it, it would go away. However, life gets busy and you skip a day then you skip two till it's forgotten. Next thing I know my lower left leg now has a football size swelling in the front of it. No doctor could give me an answer as to what was causing this. I just received the standard “If you lost weight I’m sure that would ease the swelling” answer.

Fast forward to 2008, the pain and swelling got worse due to being pregnant with my son. I googled and came across Lymphedema. I asked my doctor at the time to write me a referral for a Lymphedema specialist at a Physical Therapy clinic. He told me “You read too much online.” I vividly remember being so pissed off that I had to beg a doctor to write a referral script that could improve my life. I walked into the physical therapist office and was greeted with “You have one of the worst cases I’ve seen in a long time.” This began the journey of leg wrapping to reduce the size of the swelling before being measured for compression stockings. The confirmation that I had Lymphedema and was treating it still wasn’t good enough for my doctors. Losing weight and gastric bypass were mentioned every chance possible.

By 2010, I was at a new physical therapist (due to insurance changes) to get remeasured for new compression stockings. I was venting to her about my struggle to lose the weight. Without even looking up from her paperwork she says “Oh you won’t be able to lose it in your hips/thighs. You have Lipedema as well.” I just looked at her all confused. She went on to call Lipedema “a special fat that is near impossible to lose.” It took 10 years to be told about a condition I had been living with since age 13!

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How are you impacted by lipedema and lymphedema (and how are they different?)

The impact of Lipedema has been more mentally exhausting due to the judgement by the general public of my size . Lipedema is when fat cells absorb lymph fluid. This basically changes the makeup of the cells which in turn, makes normal weight loss options (such as diet and exercise) ineffective. It is believed to effect 1 in 11 women. Most find out about their Lipedema but googling “painful fat legs.” It can be painful when pressure is applied and bruises easily.

Lymphedema is where theres is a break in the flow of Lymph fluid, so it flows properly one way but there's a blockage or a kink in the channel it is to fluid back. This disruption causes the Lymph fluid to balloon up in the affected limb. For me, Lymphedema has been more of a physical impact. It causes painful swelling, tightness, skin breakdowns, and can make movement difficult at times. It has also made something as simple as buying shoes near impossible. The top of my feet swell too much for most shoes. I’m forced to wear tennis shoes (doesn’t go with every outfit) or ballet flats (barely any support which adds to the aches).

What made you decide to open up about your experience with these conditions on social media and how have people responded to you online?

I’d started my IG basically to show off my outfits. I hadn’t even thought about mentioning Lipedema & Lymphedema in my post. Then one day, I got my first troll who went off. It just happened at the right moment that it pissed me off instead of hurting me and I “clapped back” with information regarding the conditions. I added the hashtag to my post and realised how many more #lipedemafighters and #lymphedemawarriors there were out there. I decided to stop hiding my compression stockings on my IG from that day forward.

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What are the best and worst parts about being a body positive figure on social media?

The best part is hands down knowing that I’m helping women (and some men) realize the issues they have been living with actually have a name and that they aren’t alone. Some of the messages I’ve received are so sweet and keep me going with the IG. The worst thing would be the creepy guys that say some of the foulest comments or send nudes. These guys that just treat a total stranger like a piece of meat for their pleasure is worse to me than the fat hating trolls. The haters are hurting and feel the need to tear someone down for a sense of relief from their own pain. And while hurting someone for my own pain to stop isn’t how I’d handle things, I can understand the desire to do so. Just grasping for a sense of relief.

How have you grown since starting the PGP page?

I embrace who I am for how I am at this moment. I stopped that train of thought of “I’ll wear that when I’m smaller” or “I can’t wear that dress cause I can’t pair it with cute girly shoes.” I do things for me instead of trying to please or not upset someone else. I’m not letting these conditions stop me from going out and living life.

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When did you start getting tattooed and what made you decide to get a Disney villains sleeve?

I was friends with Tyree Patrick (way before he became the owner of Big Nerd Tattoo) through a local community theater. During his apprenticeship, he asked me if I was willing to get a tattoo. I got my first tattoo back in Fall of 2002, a tiny little roll of film to represent my love of photography. I quickly added a camera to the other shoulder and the CD artwork of the first thing I sold my photography to. My first 3 tattoos were tiny and could easily be hidden and I took a few years off from getting inked.

Then, while in the middle of my Wicked Witch & flying monkey tattoo, Tyree asked me what we were doing next. I mentioned that I loved the idea of an Ursula & Cruella half sleeve. I knew I had to start with Ursula, as she holds a special place in my heart. Growing up, I wanted to be Ariel being a redhead and all, but I’m Ursula. I’m sass and hips and have learned the importance of body language (confidence). In November of 2015, I walked into Ty’s shop expecting to start Ursula for a half sleeve when he suggested I make her bigger. I was hesitating when he said “Just let give me a chance to show you.” He then taped a print out of Ursula the size he was thinking to my arm. And dammit, he was right. As we were planning it out, it kept evolving to eventually become the full sleeve including some of my favorite male villains and their sidekicks.

What led you to start your Muppets leg sleeve and which characters will be included in the final design?

In May of 2018, we were wrapping up the Disney villains sleeve when Ty turned to me and said “So what are we doing next?” I said the only other thing that I’ve liked enough to tattoo on me would be Jim Henson’s Muppets. I knew he would be up for the challenge and I was quickly on the books for June of 2018 to start with Statler & Waldorf. I’ve let the Muppet piece happen more naturally than planned out like the Disney Villains sleeve. There were a few Muppets that I knew must be on there, but the order of which was added and placement was decided just a few days before each session. Swedish Chef will be joining the gang here in April, followed up by Bunsen & Beaker in May. I’m 99% sure those will be the last ones and then just some background filler color to blend it all together.

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How does having lipedema and lymphedema impact the tattoo process?

Tattooing Lymphedema affected limbs is a huge no-no by every medical professional I’ve talked to since I realized I had it. Due to this, the Muppet leg sleeve will be above the knee only. It is recommended to avoid any type of break in the skin, as it runs the risk of seepage or infection in a part of the body that is immunocompromised, which means it can’t adequately fight bacteria and infections.

Tattooing Lipedema affected areas hadn’t been talked about as much when I googled. I reached out the Lipedema Society on Instagram to see what their thoughts were. They asked some specialist and the answer was basically “it shouldn’t make it worse but we don’t really know what the complications could be.”

I decided to go ahead with the Muppet piece. The process has definitely been different than most of my other tattoos. The skin on my thighs gets really pink and puffs up making it difficult to see the saturation of ink as it’s being added. The extra lymph fluid in those areas can slow the healing a bit and cause some deep scabbing due to seepage. Statler & Waldorf and Miss Piggy were inked before I started the leg wrapping for new compression stockings. I had fewer issues with them. For the healing of Miss Piggy, we tried out Saniderm. I had zero reactions and LOVED it. I was pleasantly surprised I didn’t react to it, as I have really sensitive ginger skin.


So when we added Kermit next, I was all for using it again. I reacted HORRIBLY to the Saniderm this time. I believe it was due to all the extra lymph fluid being channeled up my leg, thanks to the compression wrapping. The fresh tattoo was the first source for the fluid to escape. It was the worst experience I’ve ever had. It was this combination of heat, pain, and itchiness like I’ve never felt before. I felt like I was going to lose my mind. I was obsessing over whether or not Kermit was going to scar. A friend said “how about you worry about infection?” to which I replied, “infection I can fix with medicine, but if this scars and messes up the whole look of the leg, I’ll be so upset.” I’m happy to report that Kermit (and the skin around him) healed up wonderfully. He just needed some minor touch-ups.

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What advice would you give to others with your condition who want to get tattoos?

I do not recommend tattooing on Lymphedema affected limbs. For those that want to tattoo on Lipedema affected areas, be prepared for it to be a longer process overall.. longer being done, more sessions than originally planned, more touch ups, longer to heal. Be ready for a little bit of additional pain, as Lipedema can be sensitive to touch. Be ready for possible seepage, which can create this weird feeling of the tattoo being dry and needing lotioned, yet the scab actually being really wet. It was hard at times to find the balance. While at home, I kept it uncovered from clothing as much as possible and kept it dry. If at anytime during the process you feel it's doing more harm than good, stop, it’s not worth it. You know your body, don’t push it beyond its limits. I also can not express enough the importance the level of comfort with your tattoo artist is. The Lipedema can add an extra level of stress and concern. If you don’t feel like you tattooer gets that and is up for the challenge, I’d rethink using them for that tattoo. Tyree has done all my tattoos and I can’t imagine being inked by anyone else.

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What else should our audience known about Pale Ginger Pear?

I am a pale, freckled, tattooed, naturally redheaded mother who HAPPENS to have both Lipedema and Lymphedema, but they do not define who I am. My conditions don’t make me less of a mother, sister, girlfriend, friend, or employee. Lipedema and Lymphedema don’t change how funny, caring, or pretty I am. But it also doesn’t change how much the judgement hurts.