Welcome!! =D
This forum is fantastic for encouragement, I look forward to hearing your success stories!!
My weight is similar to yours (started at 221, last weigh-in was 219 after 1 week), and although I do not know much about the types of medical conditions you have, I can share what I've been doing to see if that can help give you a jumping off point =)
I didn't want to stop cold-turkey with my life and change everything for a diet. I've done that before, and the diets last maybe a week, if I'm lucky. This time I decided to start by changing my eating habits first. My Grandma got me the calculator and some of the reading material for Weight Watchers, and Monday will be 2 weeks that I've been following it. I found, as I wrote down everything I ate and budgeted my points, that the diet wasn't so much about cutting things out, but moderating things so that I wasn't over-eating. If I wanted to eat pizza, I could have pizza, but I would need to make sure that the rest of my meals for the day were within my point range, so it's teaching me to make better decisions about what I eat (and I can still sneak in some of my comfort food in moderation so I don't feel the need to "cheat" as often). I also cut out all soda, and only drink water with the exception of the occasional alcoholic beverage if I'm in a social gathering (I always track the points for those drinks too....you'd be surprised how many points it is! I didn't take the quote "don't drink your calories" seriously till I calculated it!)
As far as exercise goes...I've never been much of a fan lol! I do have 2 dogs that like to go for walkies, and my parents have an elliptical that I use, but on average I only exercise maybe an hour and a half a week (2 dog walks @20-30 min each, 2 sessions on the elliptical @ 20 min each). I actually find I enjoy the walks more, especially now that the weather is getting nice, and my dogs like it because it helps get rid of their restless energy (I have a Sheltie, and after a day being cooped inside she paces and won't settle).
I hope his helps!!