So I was mad that NV is still messed up after the last update and decided to take matters into my own hands. But this time I intend to fix it. For me, when I try to load a game from the opening screen it crashes, but if i do the whole doc workaround thing I can load. The error is is a msvcrt.dll with error code 0xc0000005, which means (I think) that New Vegas is trying to run Microsoft Visual C++ Run-Time for Visual C++ and is having an issue due to a memory access violation.
So... Anyone want to try their hand figuring out a solution? And i mean a real solution not just a workaround i need to do every time I play New Vegas.

Edit: Okay so further debugging says it is happening on file offset 0x0000a048. No idea what that means.
Okay so I'm on a roll, file offset 0x0000a048 means that when New vegas tries to run the memory located at 0x0000a048, but when it gets there it does it has a native exception error which means: "That exception is a very generic AV (access violation) and it probably has nothing to do with memory leak which is different issues. AV happens if application is trying to access something in memory which does not belong to it. In managed application it generally caused by incorrect P/Invoke or incorrect unsafe code usage."(quoted from Ilya Tumano on microsoft.com)
So now to figure out what that even means. If anyone from obsidian or bethesda is reading this I'd appreciate it if you pushed this up the ladder until whoever makes the patches learns about it (and how to fix it).
Edit Edit: So after assailing the interwebs with a very fine tooth comb I found a clue (http://ffxiv.zam.com/forum.html?forum=152&mid=1285119405158033449&p=2&h=50#61). They say that it could be a problem with ATI radeon drivers. So even though that makes no sense, looking at all my other info, I'm going to try it. I'll keep you updated.

The final result: It works now. Turns out Catalyst Control Center was using a part of the memory NV wanted, and refused to let it have it. So reinstall CCC and it should solve this particular error.