As a general indication, any two patches/mods that change the code of the game (which in Ren'py, means also the text of the dialogues) changing the references, will not work well together.Ouch's also doesn't play well with JokerLeader's multi-mod, I ran into this problem on your last upload that I downloaded.
I am not sure about the multi-mod, but I know the walkthrough modifies the code to put some references that are then used to give the hints - but my patch also modifies the text, to put back the relationships (plus, add up one choice in the dialogue with Dr Silver, and a couple of increase of variables).
There has already been more than once the question and the answer about combining two, mine and the walkthrough. There is one user who takes the time to try doing a partial (it loses some of my patch) combination, but like mine, is a manual volunatary work.
I am not aware of anybody trying to combine mine with the multi-mod.