I found that writing my work flow  in English helps me figure out the
logical flow. For example,

If Cells(1, 1) <> "" And Cells(2, 1) <> "" Then
> > If Cells(4, 1) <> "" Then
> > Range("E2").Value = 10
> > ElseIf Range("E4").Value = 11 Then (How to apply this to 1st If
> Then?)
> > Range("E8").Value = 11
> > Else (How to apply this to 2nd If Then?)
> > Range("E2").Value = 9
> >

Check to see if cell (1,1) and cell (2,1) contain text
If so, check to see if cell (4,1) contains text
If so, cell E2 equals 10
If not, cell E4 equals 11
If not, cell E2 = 9
if Not, Cell E4 = 11