I think someone stated this earlier, but I'm going to repeat it again anyways. It seems you have a million buffs/bloodletter popping at the same time and you have to choose the lesser of two evils; Basically pick the best option at the time, which can be confusing because chances are they are all pretty good options. Example: You lose some dps if you skip bloodletter to say, pop another damage cooldown to renew your dots at a higher damage potential, and while this is happening another bloodletter procs. So it's almost like they are dangling candy in front of us, only to snatch it away.