Water was a bit of a problem for me at first, because portable water was in short supply so I could never get too far from Goodsprings.

Now it's not so bad. I'm still meh about the limbs problem, though, because doctors bags
are pretty rare and explosives are not (especially when your first major group of enemies, assuming you do make them enemies, are the Powder Gang, half of whom just chuck dynamite at you like it's going out of style). I think it's definitely manageable though.
Overall, I'm enjoying hardcoe mode a lot more than I thought I would. Aside from a brief mistake where I forgot that waiting around for 3 days for a merchant's inventory to reload would be a
bad idea, it's been totally manageable so far.