So after applying the update and fix, my auto & quick saves still won't work. I lost 3 hours of gameplay because of this (I shouldn't be expected to hard save every x minutes, either...). Any fixes, besides the ".BAK" one?

I'm having the same issue. My autosave is still back when I left Doc Mitchell's place. The patch was applied last night yet I still don't have an up-to-date autosave even though I have it set up in the setting to save on wait, rest, and travel. I doubt a dxdiag would help in this case so I'm not going to post one unless requested.

I'll try anything at this point...

EDIT: Nevermind, I doubt that's at all why there's a problem with the game...

Do you have the ability to rename this thread so the devs know this is a problem after the patch and update? I'm wondering if there was a corruption in the steam download.

Sadly, no =(

If something is worth saving, make a hard save rather then a quick or autosave.
You can always erase saves later on if you need to.

i'm still having a problem with my saves also they are all corrupt.

#1 Turn off Steam Cloud from within FalloutNV tab on Steam.
#2 Turn off entire Steam Cloud completely, from main Steam options tab.
If you are not playing the same game through on more than one PC at a time, you don't need it!
Whose dopey idea was it to enable this cloud by default, anyway?
Seems like the answer to a question nobody had asked...
#3 Get your quicksave.fos.bak and autosave.fos.bak, and save them on your desktop.
Do not simply remove the .bak suffix - or Steam will quickly overwrite your precious save with the older file.
Poof! Gone.
Name it something different, Hercules or whatever...
So quicksave.fos.bak is renamed hercules.fos and is now safe, and untouchable.

I have done all this and not lost time - but my game started Oct.19 is buggy now (since patches issued) and will not play without crashing...
A different matter, heheh.
Good luck,
Regards

...so if I already renamed the files, does that mean that those 3 hours are truly gone now...?

If there are still problems, it might be necessary to go into 'Steam>userdata>(some numbers)>22380>remote>' and rename/move/delete any saves that are still there.

That sounds fishy. What do I need to do, and what will that do?

EDIT: Not that fishy, but still, what should I do with the saves that are in there?

Those are the 'old' saves that are being written over your new ones.
They are evil. I deleted everything in that 22380 folder after I turned off the stupid cloud.

If you simply remove the .bak from your precious backup savegame, you will no longer have a copy of it once it's overwritten.
That's why you must get it outta there (onto your desktop or something) or, if you leave it in the default save directory, rename it.
If you took the .bak off it, and now it's gone - it's gone!
Stupid Steam.
I can't believe they are trying so hard to make GFWL look good!
But seriously, it's actually quite appalling.
L8R

Here's what I did yesterday: I took off the .baks and changed the old .fos' to *_old.fos. I loaded the games, but didn't save over them. Didn't fix it. I reverted it. Installed the patch, tried it again, then...nope. Today, I tried your 1st fix, and that didn't work. I just tried the 2nd fix, and that didn't work either. I'm gonna have to redo it all, aren't I?