Normal cardiac stress test (TMT) and ultrasound (Echo) results are generally reassuring for 1 to 2 years, provided symptoms do not change. Your symptoms?chest heaviness, arm pain, and burping?could certainly be related to acid reflux (GERD), especially since you are taking esomeprazole (Nexpro RD). However, because these symptoms can mimic heart issues, and you recently switched to propranolol (Inderal), it is important not to ignore them. Please consult your doctor to safely evaluate these ongoing symptoms and see if your reflux or heart treatment needs adjusting.

With proton pump inhibitors, duodenal ulcers typically heal in 4 weeks, while esophageal ulcers can take 4 to 8 weeks. Persistent symptoms like occasional vomiting and dark stools can sometimes indicate ongoing irritation or possible bleeding. While this sounds concerning, it is highly treatable. I gently encourage you to contact your doctor or visit an urgent care clinic promptly to have this checked out. They can easily evaluate this and adjust your treatment to ensure you heal safely and comfortably.

It is generally best to avoid taking azithromycin with Nexpro RD (which contains domperidone) because combining them can affect your heart rhythm. Additionally, antacids like Rantac MPS can interfere with how your body absorbs azithromycin, so they should be taken at least two hours apart. Your symptoms of heartburn, chest and back pain, stomach noises, and breathing discomfort are likely related to severe acid reflux. However, because chest pain and breathing difficulties require careful evaluation, please consult your doctor before starting the antibiotic.

Since pantoprazole (Pan 40) and esomeprazole with domperidone (Nexpro RD) haven't brought relief despite excess acid, you may have refractory GERD. Sometimes, optimizing the timing of your generic proton pump inhibitors or exploring options like potassium-competitive acid blockers can help. Given your body pain and mild depression, certain low-dose medications can address both nerve sensitivity in your gut and your mood. I highly recommend discussing these options, along with potential surgical evaluations, with a gastroenterologist to finally find you some comfort.

It is very possible that your new symptoms are related to your current medications. The antibiotic Levoflox 500 (levofloxacin) can commonly cause weakness or fatigue as your body fights the infection. Nexpro RD 40 (esomeprazole and domperidone) can sometimes lead to digestive changes like constipation. Additionally, antihistamines like Blexten M (bilastine) may occasionally cause mild urinary changes or tiredness. While these symptoms are uncomfortable, they are manageable. Please stay well-hydrated to help with both constipation and urination. I highly recommend contacting your prescribing doctor so they can safely review these symptoms, especially while you are on the antibiotic.

Your fluctuating diastolic blood pressure, tremors, and anxiety are closely connected. While propranolol and clonazepam are effective for managing these symptoms, continuing clonazepam long-term requires careful supervision by your doctor to avoid dependency. Since your symptoms recur when stopping, further diagnostic evaluation?such as a 24-hour blood pressure monitor or a consultation with both a cardiologist and a mental health specialist?is highly recommended.