Does jsawyer work with the other realism tweaks? They look pretty interesting, but I probably should start a new game with just one or the other.
I didn't play the whole game but I didn't see problems.
But I had to mod extensively Arwen mod to make it playable, otherwise it's nigh impossible. So I either hand you my version, or I don't actually recommend at all to use that mod the way it is by default.
There remained a few quirks that I think I didn't end up fixing but that should be fixable: for example in both standard Fallout and jsawyer the stimpacks directly give you back health. There are full stimpacks and weaker version in jsawyer. But Arewn only scripts one type of stimpack, and it won't heal you. So I think the game ended up having two types of stimpacks that in the end had the exact same effect (so I should go and add a new custom script to apply only to the weaker stimpack).
In Arwen mod stimpack only stop the bleeding (they reduce a value by some extent, same for bandages). When you're stable and not bleeding you'll then heal over time. And using stimpacks one a second after the other only wastes one of them, since it also needs some time to work and run its script.
Jsawyer mostly fix a few things and rebalances what kind of stuff you find in the world (weight of items, quantities and so on), I removed that part of Arwen mod, and only use the modules (and not all of them) that add the scripts. So these areas don't really overlap.