I can see Gucci's point of view as 4 years is a long time to spend working on a R when you could have perhaps found happiness with another who would treat you with the greatest respect and love you deserve. But having said that each situation is different and each person makes a conscious decision on how long they will spend DBing with the hope of a reconcilliation. For some they may move on very quickly, others not at all and others after a lengthy period of time.
I know for me, I would be in it for the long haul and I think I would have a hard time putting a time frame on it. Look at me, still having issues over what I think are really petty things but still I continue to smile and DB my little tooshie off.
You have had a lot to deal with in those 4 years, ill health, surgery and more surgery to come, which in a way makes DBing a bit more of a lengthy procedure for you as you have to focus 100% on yourself when getting ready for surgery and for the recovery period in order to get well, so whilst it may be 4 years for you Cas it has been more likely part time for 4 years whilst you looked after yourself.
Given that H is now making some more positive steps toward you, I wouldn't exactly be in any hurry to put an end to anything until you give these changes a bit more time and also you have to think that you have some more surgery coming up and I don't think you should be adding to your list of things to worry about or think about fixing.