For as long as I can remember, I have needed external validation for just about anything that I do. When I was in school, I always wanted to be the top of my class. I would come home with an 86% on a math test and my mom would jokingly say 'Where's the other 14%' because she knew that I wasn't happy with only 86%; it's not 100%.

This external validation has driven me to achieve many goals. Every time a boss of mine says 'Great job' or 'What would I do without you', I always want to work harder to show that I'm 'the best' or 'worth it'. Keith jokes that I do well with a gold-star system - meaning every time I do something well, I expect a gold star and that respond well to positive reinforcement. By the time I was 24 years old, I had earned three degrees, one of which is a master's degree and I have always prided myself in being the youngest person to ever... or the best person to ask about... or the funniest; I like being known as the funniest.

Breast cancer is no different really because I usually am the youngest person that anyone has heard of getting breast cancer - I realize that I'm not the youngest person to ever be diagnosed but very few people know of anyone who was as young as 26. I guess in some respects, breast cancer has met my previously mentioned criteria; I'm the youngest, the best person to talk to (I've had a few people say 'Talk to Katie about [insert breast cancer topic here], I know she's dealt with that') and I have used humour a lot in the past year.

I think my need for external validation has morphed into projected expectations that I assume others are putting on me. So, what I mean is, because I rely so much on others to value my worth, I think when it comes to me meeting an expectation, I assume that others are putting as much pressure on me as I'm putting on myself and by assuming this, it only adds to my own expectations.

I think when I was diagnosed and even while I was in treatment, I felt like I got a bit of a free pass to react to anything, any way I wanted. Like if I was to cry all day, no one would say anything because it's to be expected. Or if I cursed like a sailor about not having a breast, no one would try to calm me down because it's understandable. On the days that I didn't leave the house, I rarely got pressure from anyone to go for a walk because they knew that I was physically drained. But now, now that the physical side effects of treatment are fading, I feel like the expectations are increasing.

I constantly hear that I need to lose weight - by the doctors, the professionals, strangers and that little voice in my head. I feel like I need to eat perfectly, not properly but perfectly - I feel like outsiders look down on me if I eat out because of the 'stuff' in our food these days. Do you know how much pressure there is to be a health nut now that I've had cancer? I feel like I'm expected to be back in action at work when really my brain is getting such a work out. Maybe I feel this way because I used to have expectations on individuals who had cancer, I thought when treatment was over, cancer was over but now I understand that there's no way to stop having cancer, instead it just moves from your body to your mind. Everyone seems to have an opinion as to why I had cancer (even though my whole oncology team couldn't figure it out) and the reasons range from stress to what we eat to genetics to our environment and it's hard to not feel like 'they' are blaming me for having cancer. In other words, 'If you didn't have so much stress in your life, you wouldn't have gotten cancer.'

A few weeks ago, after only being back to work for two or three weeks, I had a bit of a breakdown. Everything was making me cry and nothing could stop me from crying. I think because I felt so tired after only working 5 hour days, I felt like I was failing. No one said anything to me or even implied that they were disappointed in me but because I wasn't able to jump back in to the swing of things, after being off for a year, and after going through cancer, treatment and now being on cancer drugs that make me so tired, I felt like I was failing at returning to work. And by not getting a daily dose of 'Wow, 5 hours a day, that's so impressive. How do you do it?' I felt like I wasn't going back to work 'properly' or 'good enough'. I sound crazy, don't I?

I know not everyone seeks the external validation that I do or puts as much pressure on themselves, but I think the expectations of others do start playing a role in everyone's cancer journey so if you know someone who is going through treatment, returning to work, or celebrating their 20 year cancer-free anniversary, try not to put any expectations on them, maybe even tell them how proud you are of them because this cancer thing is so unpredictable and we put enough pressure on ourselves.