Apparently the game was patched for me between 5am central this morning and now, 1pm. When I try to load the game now, it brings up the normal little window that you can change options on and start the game from. When I click to start the game I get a pop up asking if I wish to allow Bethesda to make changes, etc. I click ok on this and it goes away, proccesses for a second then pops up the same window as when you first start the game.
I am completely locked out of the game. Steam is not downloading so I know the patch is done installing. I have restarted my pc. I'm not sure what else to try.