I created the file, did an update, and then rebooted but mythtv still did not start up.
I then tried an update again but nothing needed to be updated.
I then installed mythtv since apparently it was not installed and rebooted but mythtv still did not start up.
While looking through the available packages I noticed pluto-myth-player was not installed so I installed it and rebooted and finally mythtv started up fine and appears to be working as expected.
It should be noted that I'm running a hybrid-core with no MD currently.
It seems very strange that an update would delete a critical component like this.