First off, I like your new picture, you look radiant
Second, it sounds like losing weight really shouldn't be your priority right now. Those extra 30 pounds aren't causing your joint pains, I bet. You need to get healthy and it sounds like there is a real medical issue there. And if there's healing to be done, deficits and workouts may not be the best things. If for instance your pains are fybromalachia-like, that will affect the type of exercise you can and should do. My advice would be to find out exactly what's up with your join pain etc. and devise a plan for it together with a professional. Are you still doing the physical therapy work?
I mean, what do you want to be in 30 years from now, thin and in pain all the time? Or chubby and pain-free?