It's more difficult now, especially in apocalypse, but personally I like it a lot. Getting knocked over is surprising but it hasn't killed me quite yet. My tips:
Always take the hearing perk. Ive even dropped tough skin to pay for it.
I clear houses with the shotgun out. Push loners down and stomp or knife. Shoot and leave if 2-3 corner you. Getting cute with melee is where you'lll die.
Hunter is great. Sneak, knife, gun. I sneak or sneak run all over the place and it levels fast.