I dont know about you guys but i find its extremely easy to die in the game, which I have no problem with, since using guns you get an edge on most opponents and after battle you can stimpak and eat food to heal.. BUT if you decided to go unarmed or melee throughout the game and decided to keep the difficulty up how would you manage the game???

Maybe in small corridor buildings u can wait around corners but out in the open desert or in a long hallway? 90% of enemies have guns and will destroy you before you get to them.. and lets not forget about mobs chasing you. Then what?

I can understand if you just play unarmed for roleplaying and turn the difficulty to really easy but lets say you wanted to play on really hard and went unarmed or melee?? Impossible??

I could easily go Melee or Unarmed if I wanted to. I have 5 Endurance but much is in your armour for damage stonewalling. Good armour and a good weapon.

Edit: Med-X helps a bit too.
Edit #2: Psycho as well if you want.

I'm playing a solid Unarmed character right now in hardcoe/Very Hard and while there are challenges (swarms of Cazidors and Deathclaws) it is far from impossible. With the right weapons, armor, and character build you can take on most threats, and those mentioned above can be fought off with liberal use of chems and backpedaling.

Once you get the Ballistic Fist, there are few threats that can out damage you. Also, Toughness Perk and Stonewell are your friends. VATS, however, is your worst enemy. Slow attack animations while already in the midst of the enemy, and the ridiculous VATS defense buff from Fallout 3 now nothing but a bad memory, you will die A LOT in VATS using Unarmed weapons.