May I offer a differing perspective on your near-death experience, by changing one word: It was a near-life experience! (yes I'm borrowing that from Fight Club :-)
But truly, nothing makes us understand and appreciate life quite like an experience that brings us face to face with death, as you can surely attest. If you do care to share the experience some day, I'm sure you know well that you'll find nothing but support on this site.
In any case, glad you've found the longer term motivation! Stay with it, steady eddie style, and lean on others who are similarly seeking fitness changes -- or who have already had success -- for the positive vibes to stay with it. Just like we do with the liberty movement.
And seriously, if you're looking for a way to drop that 40" number effectively, have a look around that LeanGains site (start with the LeanGains guide), and of course don't take his word for it. Google for more info, successes, failures etc. It's not a diet fad, it's a complete lifestyle change -- by simplification (intermittent fasting). It has simplified everything for me, from eating to exercising, and over a month in I've had considerable results that I haven't achieved by other methods before.
Sorry if that sounds like an infomercial; it's something I'm enthusiastic about because of how well it's gone for me, and really how relatively easy it will be for me to do it forever. I'd feel like I'd be guilty of neglect if I didn't mention it when the subject comes up.
In any case, however you decide to go about it, may the wind be always at your back! Best of luck and happy new year!