This morning I started my seventh round of ATRA (al trans retinoic acid, or Tretinoin), and I already feel crummy. In the past, I've been better prepared before a round starts, with my medicines organized, my survival supplies stocked (G2 Gatorade and blue corn tortilla chips). This round, I started a day late because of a project at work, and I didn't get home from work until 10pm last night. I didn't even take the time to think through my strategy for the pain / nausea management (each round I've tried different combinations of drugs and timing). Yes, I was busy at work, but also, I think I'm experiencing a bit of treatment regimen fatigue. By this evening, when I'm really feeling crummy, I'm sure I'll be regretting my lack of preparedness, but at least my dad will be here shortly to help. Only one more round after this!