Dr Annie Marshall
Dr Marshall graduated from the University of Sydney with Honours in 2004, and after her basic hospital training did a 6 month residency in Obstetrics and Gynaecology, during which time she attained her Diploma with the Royal Australia and New Zealand College of Obstetrics and Gynaecology. Dr Marshall then moved to rural Western Australia where she undertook her General Practice training at a very busy rural practice, which included on-call obstetrics and hospital cover. During this time she completed a Diploma of Child Health through Princess Margret Hospital. She returned home to Sydney in 2010 and has continued working in General Practice while juggling life with three small children.
Dr Marshall is affiliated with the Royal Hospital for Women and RPA for the provision of antenatal shared care. While she has a keen interest in Women's Health and Paediatrics, she enjoys the diversity that general practice provides. Dr Marshall is experienced in inserting contraceptive devices including Mirena and Implanon.
COVID Vaccination Update- July 2021- Pfizer
Rozelle Total Health has been selected by the government to provide our patients and community with the Pfizer/BioNTech COVID-19 vaccination. We will commence Pfizer vaccinations on 8 July 2021 in line with government regulations.
The following people are now eligible for the Pfizer COVID-19 vaccine:
- All adults aged 40-59
- All Aboriginal and Torres Strait Islander people aged 16 to 59
- NDIS participants, and carers of NDIS participants, aged 16 years and over
- Temporary visa holders aged under 50 years who are currently in Australia and have been approved for return travel to Australia through the travel exemption process
- Quarantine and border workers under 60
- Health care workers under 60
- Aged care and disability care residents and staff under 60
- People aged 16-59 with an underlying medical condition or significant disability
- Critical and high risk workers aged 16-59 and over including defence, police, fire, emergency services and meat processing.
- Individuals under 60 with an Australian Border Force outwards travel exemption in an eligible category
Only the eligible patients will be offered the Pfizer vaccination. If you are over the age of 60 years you are advised to have the AstraZeneca vaccine as per ATAGI guidelines. Your last chance to get your AZ vaccine at RTH is Sat 10 July, please book now to avoid disappointment. You will be directed to a vaccine hub after this date.
All patients who have had a first dose of AZ should continue with the second dose of AZ as per ATAGI advice
Please confirm your eligibility here before booking an appointment
- Our appointment availability is limited by vaccine availability
- There is no waiting list. All appointments will be made available online as stock is delivered each fortnight. Bookings can be made here.
- These appointments will run to a strict time schedule. Please bring your valid Medicare card and/or other form of ID to your appointment and wear appropriate loose fitting clothing to allow us to access your left shoulder in a group setting. You will be vaccinated in groups of 5 people and be required to wait 15 minutes post vaccination to watch for any adverse reactions.
- You must book your second dose when you book your first. The interval for Pfizer is 3 weeks apart. You will automatically be directed to a date 3 weeks from your first dose appointment- please do not deviate from this.
- Your appointment is for the vaccination only. If you have any questions, concerns or are unsure if the vaccination is right for you, please call us on 02 9087 4600 or book an appointment via HotDoc with your regular GP on a day any time prior to your vaccination appointment. Please follow this link for up to date information about the vaccine.
- You will be required to complete a consent form. This will be sent to you via email from HotDoc once your appointments have been booked. You must complete this as soon as possible. You will not be vaccinated if this is incomplete.
At this time we request you do not call reception in relation to booking appointments. All appointments will be made available online. You may need to check back at a later date as more appointments become available. Keep an eye on our website and like us on Facebook for updated information.
We thank you for your patience whilst we manage and oversee this extensive and unprecedented immunisation roll out.
Rozelle Total Health
What causes abdominal bloating?
Contrary to what many people believe, bloating is not necessarily due to too much gas in the stomach. Researchers have performed studies on patients who feel bloated using CT scans, and shown that they often do not have any more gas in the belly than people who have no symptoms. Excessive gas production probably plays a part, but does not explain the whole picture.
So if too much gas isn’t the main cause of bloating, then what is?
There are several different factors which may play a role:
- Too much water or liquid travelling into the small intestine. Certain food contents drag liquid into the intestines, which has been shown to cause the sensation of bloating
- Constipation and backed up stool in the colon (faecal impaction) can cause the sensation of bloating
- “Sluggish bowel,” or poor motility of the bowel – where the bowel pushes gas through very slowly
- Altered function of the diaphragm – the diaphragm is the big muscle between the chest and abdomen that moves up and down when you breathe. When you eat and drink, this muscle should relax and move upwards to make more space in your abdomen. Studies have shown that in people who bloat, the diaphragm incorrectly moves downwards, causing the belly to protrude.
Change your diet to reduce bloating
- Avoid fizzy drinks
- Some fibre supplements may help, but need to be chosen carefully. Fibres that undergo a lot of fermentation by gut bacteria can make bloating worse (e.g. whole wheat bran). The best are non-fermentable fibres such as sterculia (Normafibe)
- Trial cutting out dairy and/or gluten for one month, as conditions such as lactose intolerance and gluten sensitivity are very common causes of bloating in Australia. If you don’t feel better after one month, then reintroduce them into the diet.
- Trial a low-FODMAPs diet under guidance of a dietitian – this is a diet developed in Australia and now used all over the world for treatment of bloating. Foods high in FODMAPs increase the amount of fluid in the bowels, which in some people can lead to bloating and swelling of the abdomen. Through a process of elimination and reintroduction, the dietitian can assist you in finding out which ‘high-FODMAPs’ foods are the most problematic for you
Natural remedies that help with bloating
- Iberogast is a herbal supplement that has been shown in clinical studies to be helpful for bloating and other gut symptoms in irritable bowel syndrome. You can find it at most pharmacies.
- Kiwifruit has recently been shown to be beneficial for helping gut motility (ability of the bowel to contract and propel digestive contents). If you don’t like the fruit, you can take kiwifruit extracts instead!
Other strategies to help you with bloating
If you also have constipation, try taking regular sterculia fibre or laxatives that you find over the counter from the chemist. Usually, getting rid of the constipation helps the bloating too.
When to seek further advice or support
See your GP or gastroenterologist if your bloating is not improving with the above measures. You should also see your doctor if you have other symptoms along with your bloating such as unintentional weight loss, vomiting, being woken up at night to open the bowels or due to pain, or a change in bowel habits. These may be indicative of an underlying disorder rather than just ‘simple’ bloating.
Your doctor can perform a physical examination and may order further investigations such as blood tests, x-rays, stool specimens, or gastroscopy and colonoscopy. Your doctor may recommend other medical treatments for bloating such as prokinetics (medicines that stimulate the contraction of the gut and propulsion of gas and other contents) and medicines that change the composition of the gut microbiome in favour of more “good bacteria”.
We are pleased to advise that Rozelle Total Health has been approved to deliver COVID vaccinations to our community. The rollout will be staged as per the Dept of Health and we will be starting with the phase 1b.
Please note - We have not yet received any vaccination stock!
We are busy planning how best to deliver the vaccine to you safely and quickly so please do not phone us at this stage regarding vaccination. We will notify you as soon as we are ready to take bookings.
If you wish to discuss your personal circumstances, or need help deciding what is right for you, we recommend booking an appointment with your GP.
RTH is keeping a close eye on the upcoming release of a COVID vaccine. The indications are that approval of a vaccine is fast approaching and will start to become available in the first half of 2021.
The release of the vaccine will be completed in stages. The most vulnerable people will be vaccinated first. There will be guidelines which we will have to comply with. We continue to wait for further information from NSW Health.To receive updated information make sure you like us on Facebook. Please also share this message with anyone you know who might benefit from the information.Thank you for continuing to help stop the spread
Dr Santosh Sanagapalli is a local Rozelle husband and father, consultant Gastroenterologist, and specialist in diagnostic and therapeutic endoscopy. He enjoys providing holistic, empathetic and comprehensive care to patients with a wide variety of problems affecting the gastrointestinal tract. He has a particular focus on high quality endoscopy, reflux and disorders affecting swallowing, and the role of dietary therapies in managing digestive health. He prioritises good communication with his patients.
After graduating from UNSW, Santosh completed his training in internal medicine and gastroenterology at St Vincent’s and Concord Hospitals in Sydney. He undertook further sub specialised training in swallowing disorders at University College London Hospital, one of London’s largest and most prestigious referral hospitals. Upon his return to Sydney he was appointed staff specialist at St Vincent’s Hospital where he leads the oesophageal disorders service.
He performs endoscopic procedures (gastroscopy and colonoscopy) across the St Vincent’s Healthcare campus in Darlinghurst (both private and public) and at the Alexandria Specialist Day Hospital.
Government changes to MBS funding for telehealth came into effect on 1 October 2020.
Rozelle Total Health continues to offer care to our patients both face to face and via telehealth. We are pleased to offer this choice so patients may elect to access care in the mode that best suits their circumstances. There are some clinical settings where a face to face appointment may be required to complete the assessment. There may also be circumstances where we request you do not attend a face to face appointment (eg you or your GP may be infectious) and you will be offered a telehealth consult.
We are pleased to advise that medicare rebates remain available for telehealth consultations provided the patient has been seen in person at the practice at least once in the preceding 12 months. Private fees are applicable to all consultation and we are not able to offer routine bulk billing. The government requirement to bulk bill certain patients due to COVID has been removed and the payments to GPs for doing so have ceased.
We are a privately billing practice and the fees remain the same for both face to face and telehealth consultations. Payment is required on the day of service. Where you start with a telehealth consult but are required to attend for a face to face review on the same day - you will only be charged once.
If you have any questions or concerns please get in touch with our service team.
Rozelle Total Health
BIG CHANGES to prescriptions are taking effect in the coming weeks. Scripts will be delivered by ‘token’ to your email or mobile phone! Please make sure we have your TOTALLY up to date details here:
Charlotte is a local Mum who is focused on building long term, holistic relationships with her patients.
She always leads with kindness, is caring by nature and likes to ensure the best possible overall health and wellbeing outcomes for her patients.
Along with her experience in general practice Charlotte has an interest in Women’s health (including antenatal shared care, contraception and Implanon insertion), paediatrics and dermatology (including skin checks and excisions). She has experience administering iron infusions.
Charlotte has a Bachelor of Medical Science, Bachelor of Medicine and Surgery and is a fellow of the Royal College of General Practitioners