I haven’t figured out how to embed a slideshow into my post, so please follow this external link to see our photos from Kuala Lumpur.

CLICK HERE FOR PICTURES!

Here is the narrative for our trip 🙂

We really wanted to take a trip out of Singapore so a group of us decided to go to Kuala Lumpur (KL), it was a 5-hour bus ride from Singapore and only cost about S$100 round trip. We left on Friday afternoon at 2:30pm and arrived in KL around 7:30pm. The first experience to greet us was learning to deal with taxis drivers. The bus dropped us off at Corus Hotel but our hotel was the Renaissance. We weren’t quite sure where our hotel was and the taxi driver offered to take us for 50 Ringgits (!).

The convert from Ringgits (MYR) to USD, divide by approx 3.5

So approx 14USD, now in the US that price wouldn’t be too bad but in Malaysia that’s an extreme amount considering on the taxi meters it is 2MYR to start and 0.20MYR for each min or km. We told the guy “no”.

Instead we went inside Corus Hotel to ask the Concierege for a map. We weren’t well planned for this vacation since we planned it so quickly and didn’t have any travel guides or maps. The concierge ended up pointing out our hotel in the skyline, it was only maybe a 10 or 15 minute walk away. The taxi should have only cost 5MYR! We told the concierege about the taxi driver outside and told us to be careful with the taxi drivers around KL, some of them are sneaky. The taxi drivers hardly ever use the meter and if they do, sometimes the meters are fixed so that they increase faster or the driver will drive you around the long way to make more money. Instead, you have to bargain first with the cabbie before getting in or else you may get ripped off. The cabbies will not cheat locals though so if you can pretend you’re Malaysian, they will turn on the meter and be honest about the cost.

Since we were only there for the weekend, we packed light so the walk to the Renaissance wasn’t difficult. We were pleasantly surprised when we arrived in our rooms as they were much nicer than we were expecting for 65USD. The bed and pillows were super comfortable too, much better than our bed in Singapore. I knew it was going to be hard to leave…

Once the entire group arrived in KL, we headed out to Bukit Bintang to find a place to eat. We ended up at an Italian restaurant called L’Opera. After we were pleasantly full, we walked around a bit before heading back to rest up.

KUALA LUMPUR DAY TWO – September 15, 2007

Ron and I had volunteered to wake up early and wait in line for tickets to go up the Petronas Twin Towers. The tickets are free and the giveaway begins at 8:30AM, so we figured arrive before 8:15AM should be adequate time. Well, when we got there, a huge line had already formed and snaked around the ticketing area. Once the ticketing opened, we had about a 30 minute wait so it was pretty efficient. We had a group of 9 and asked for 3:00PM reservations.

We had a little breakfast at the food court upstairs which was really cheap! Our breakfast was less than 4USD.

Afterwards we headed back to the hotel to meet up with the others and stopped at the Visitors Center on the way there. We met up with the rest of the group but some were delayed so we headed to a coffee shop to have some additional coffee, it was a Coffee Bean and Tea Leaf cafe. I had a tropical passion tea latte, something I don’t think they have in the US.

Our plans for the rest of the day were to head to Chinatown on Petaling Street for shopping. There were tons of vendors and you can bargain them down. I was looking at some cute imitation handbags but still too expensive for imitation. The one I liked was always quoted as 85MYR and vendors wouldn’t go below 60MYR so I passed. We had lunch inside the mall at the end of Petaling Street before heading to Petronas Twin Towers.

At the towers, you watch this video all about the Petronas company before boarding the elevator to the walkway between the towers. One tower houses Petronas offices and the other side is leased to multinational companies and the mall. In between is actually the home of the KL Symphony. Recently Indonesia had a few earthquakes and they said the towers sway, they were actually designed to sway 75cm (!) just in case of earthquakes or other natural disasters.

After the towers, we headed to see some more sights while it was still light out like the Central Market, the oldest building in SG, and some temples. We didn’t quite make it to the temples because they were closed and it was raining hard. So we ended up back at the hotel for a swim and we all agreed to meet at 9pm in the lobby to go out for dinner.

The hotel concierge recommended a restaurant called Bijan which was Malaysian food. It had won an award as best restaurant in KL in 2005 so we thought it’d be super expensive but it was actually pretty reasonable, cheaper than the Italian restaurant the night before. Check out pics of the dishes we had. For dessert everyone shared one piece of Durian Cheesecake… so what do you think everyone thought? Well, let’s just say that now everyone can say they’ve tried Durian but won’t likely try it again. Durian is okay once you get over the smell 😛

We attempted to go to a bar afterwards but because Ron and I were not dressed appropriately (no shorts allowed and no flip flops), we separated from the group and went back to the hotel. We felt bad that the group kept on insisting that we find a place we could all go together. They eventually found a place and sounds like they had a good time.

KUALA LUMPUR DAY THREE – September 16, 2007

The next morning, Ron and I headed out to the Batu Caves by taxi. The rest of the group was still resting so we thought we’d go ahead. Unfortunately we lost contact with them most of the day because our phones ran out of money for roaming! We’re still getting used to the cell phone (or handphone as they call them here) policies here.

It cost approx 25MYR by taxi to the caves and the cabbie offered to stay and wait for us for 90MYR(!). That was too much so we figured we’d find out own way back since we didn’t know what time we’d be done. So we had a bite to eat at one of the many vegetarian cafes before heading up those 272 steps.

In the humudity, those 272 steps were rough! There were lots of other people going up and down and there were monkeys running around all over. Those monkeys are bold in that they come right up to you to beg for food or will swipe things out of your hands. They also hiss and swipe at you if you make sudden movements toward them. We stayed away and just watched other people giving them bananas and drinks. One monkey had a box drink and was trying to figure out how to open it, unfortunately he had it upside down and all the liquid dripped out the bottom yet he kept on trying to bite it open from the bottom. Not too smart those monkeys.

I wasn’t able to take good pictures of the caves because it was too dark but they are very grand and there are areas to worship within the caves. We took those 272 steps back down and took a taxi to Chow Kit, a shopping district.

Chow Kit wasn’t much different than Petaling Street. Less brand name items but more practical and inexpensive things. We headed to the KL Telecommunications Tower after walking through Chow Kit.

At the KL Tower, we bought tickets to take the elevator up and just took in the sights. They do have a rotating restaurant where you can have brunch and dinner and also an area where they can host weddings.

Afterwards we were able to meet up with the remaining people in our group and we just all sat around to chat. We were really tired after all the walking in the past 2 days. We ended up going out to eat at TGIF since we were craving fresh salads 🙂 The food is exactly the same as the US. The coffee ice cream dessert was really good and satisfying too.

Our bus was at 11:30PM to take us back to Singapore. We arrived in Singapore at 4:30AM. It wasn’t a pleasant bus ride back as you are woken up in the middle for a rest stop and then near the end for immigration. It was nice to sleep in a few hours (but not quite a enough) before I went on a tour of Singapore provided by INSEAD. Look for that on the next post.

Today a group of the partners went ice skating! I really haven’t been in quite a while so it was a little intimidating but worth a try 😛 We went to Fuji Ice Palace in Jurong East. There were people there having lessons which included little kids under 5 years old. Those little kids were good! But then I guess they do have a lower center of gravity so it’s not as easy for them to fall.

It was slow starting with lots of wall hugging but eventually I got the hang of skating again. I don’t like going fast and it’s kind of dizzying to go around and around and around so we only stayed for an hour and a half before heading back to INSEAD for lunch.

In the afternoon we also had a talk which we were invited to called Business Etiquette and Living in Singapore. The talk was given by a relocation expert to help us settle into Singapore lifestyle. It was a 3 hour talk but well worth the time, she gave us a lot of background on Singapore and also current events.

Some highlights:
1. Singapore has 4 official languages: English, Malay, Mandarin, and Tamil
2. “Salamat Datang” is “hello” in Malay
3. “Vanakkam” is “hello” in Tamil
4. Singapore hs 42km by 23 km (26mi by 14mi)
5. 4.3 million people with approx 1 million tourists per month (!)
6. Singapore has grown larger in size due to reclaimed land. The land was originally taken from its own mountains but now it’s being purchased from Thailand and Vietnam
7. Singapore actually has rainforests!
8. Sir Stamford Raffles purchased part of Singapore in 1819 (you see a lot of buildings named after him and many historic momuments)
9. Lee Kuan Yew was the first prime minister, 1959 through 1990!
10. Singapore’s independence day is September 8, 1965
11. Use your right hand for everything, the left hand is the “dirty” hand
12. Don’t show people your feet, it’s disrespectful (ie, crossing your legs and the soles of your feet are showing)
13. “Tipping is not encouraged”
14. Residents are required to put money into their central provident fund (CPF) for their retirement.
15. It costs approx S$30-40,000 to get a “Certificate of Entitlement” (COE) in order to buy/have a car (you still have to buy the car!)
16. “Kiasu” means “afraid to lose” in Hokkien, you say it to people when people are being pushy without realizing it (ie, pushing their way into the MRT without letting people get out who want to exit)

That’s just a taste of what she talked about with us. She also gave us a great list of places we should visit while living in this area.

Today I visited the practice site that I hope to be working in. The head of the pharmacy dept Prof Chan, Joyce, and I visited Tan Tock Seng Hospital. We met with two other pharmacists, Annie and Yee-May to talk about the opportunities in their hospital.

It sounds like I’ll likely be doing inpatient and/or outpatient anticoagulation. In the inpatient setting, patients who have previously been on warfarin therapy, new starts, and some heparin patients are monitored. The service seems very similar to UCSF in that a patient roster is generated each morning who were ordered warfarin the night before and each patient’s chart is reviewed for notes, medication orders, and resulting AM lab values. Recommendations are made only when necessary and notes are written in the chart. If no recommendations or notations needed then no note is left. The pharmacist is in charge of providing warfarin counseling and setting up outpatient follow-up. The only major difference is that pharmacist can order lab draws for the patient, the PT/INR. Pharmacists cannot write medication orders, they do not have prescribing rights in Singapore.

The outpatient setting is different than UCSF in that they do not use point of care tests, all patients require a lab draw. Also, prescriptions must always be co-signed by a physician. Things like verbal orders do not exist here in Singapore and there is a national clinical pharmacy anticoagulation protocol which is located here if you are interested. Also, patients are not followed for their lifetime even if they require lifelong anticoagulation, these patients can “graduate” from clinic and be seen by their primary doctor less frequently if they become stable on their warfarin dose.

Oh, and there are only 3 strengths of warfarin here: 1mg (brown), 3mg (blue), and 5mg (pink)! So any pharmacists out there reading this blog, keep a watch out for patients from Singapore and them saying the take a brown warfarin tablet, there is a potential for medication error!!

It’s all very different but very interesting, I don’t think I’ll ever get bored.

Now I just have to work on getting my application into the Singapore Board of Pharmacy which I hope to complete soon so I can start my “pre-registration” training, sounds like I’m going to be an “intern” for at least 3 months.

After our visit, Prof Chan treated me and Joyce to coffee and snacks at Starbucks. TTSH is a very different hospital, it houses approx 1200 patients but it’s building is so large that is also houses a large outpatient pharmacy, outpatient clinics, a huge food court, shops (like Starbucks, McDonalds, 7-eleven), and probably lots of offices. It’s also across the street from a mall and right across the street from the Novena MRT station. It’s almost hard to tell that it’s a hospital.

I’m sure I’ll have plenty more to share once I start working, I can’t wait!