Well here's what I do.
I have 100% Realism, except usualy I have stable periscope view(It's a mounted piece of equipment, not a device being physcially held FYI.) For me, dead is dead, this enforces me to make wise decisions and understand the consequence. I save periodaclly to deal with CTD, but if I screw up, then whats done is done. Never going back to anything, and always try to take care of the crew. Right now I'm on my 3rd patrol, for the first; the Diesel engines went kaput.

. I currently run WAC 4.1 with SH3 Commander. Its different then GWX, for me WAC gives the most sense of realism and adventure. I actually sunk 2 destroyers, of course as you read above I suffered the concequences.