HOLY **** , i dont know how familiar you guys are with Fo4 but im on a survival play through and you cant save unless you are sleeping in a bed.
Im trying to get to kellogg right now and the landmines one hit me.. ive been at this for hours. Its so infuriating. But so so satisfying
If I remember correctly, you also have to account for hunger/thirst, and deal with injury differently.
I like doing similar things with Skyrim... all-out survival mods... where you have to eat/drink/sleep... and exposure is a factor... have to wear warmer clothes in the colder areas, get dry by a fire, etc.
Good stuff.