Obviously I am not Cathe, but I am going to try to give you my ideas since you and I sound very similar (40's, 2 kids, demanding job..I think we are both in anes).
I get up very early to exercise (4:15am) so I can get to the hospital by 6:30am. The key to my motivation to getting up that early: I must get in bed by 9pm. I have the whole family alerted on that, and mostly, they are helpful in at least being quiet while Mommy is trying to fall asleep. As my fatigue grows, motivation drops off. If I get some sleep, I suddenly have renewed motivation. I also plan out my workouts, so I know what I am scheduled to do each day. I purposely schedule my rest day during the week rather than the weekend, since I have more time on the weekend to sleep and exercise
From your e-mail, it doesn't sound like you struggle with your weight, but I do!!! So, one of the "deals" I make with myself is that before I take an unplanned day off, I have to weigh myself. After that, if I still want to take a day off, I do it. Other strategies: plan a reward ("if I exercise 10 out of the next 14 days, I'm going to get a pedicure" etc.) I also schedule longer workout sessions on the weekend, so that my total exercise time for the week is 7-9 hours (makes up for missing a workout or two during the week).
Finally, NEVER beat yourself up about this issue. You are not lazy, a bad person, uncommitted etc for having trouble getting motivated to exercise. You are human and have many, many demands on your time and your mind. The amount you do in one day at work and at home likely qualifies you as super human. I bet folks wonder how you do it. The answer to that is that you prioritize and work your behind off. So, when you have those talks with yourself, be kind, realize how much you are balancing, and remind yourself that being able to exercise is a gift, that it really does feel good, and it is a time to focus on your own well being.
Good luck,
