Ahhhh the question that every yakker has pondered but were afraid to ask.
It depends on the scenario. I was in a situation spearfishing in the south pacific as a kid. I knew I couldn't make it to the public restroom so I dove down about 15 feet...grabbed on to the coral and let torpedoes go. It was truly a sight to see. I do believe there was high fat content because, I swear, those babies executed a surface breach much like an LA Class Nuclear Sub.
While kayaking the flats, I was way too far from the launch and any restroom...so I told my buddies to go ahead, I would catch up with them. I got out of my yak, ensured which way was down current...pointed in the right direction and let loose...pardon the pun.
3rd Scenario, I fishing BYB, mother nature gave me a conference call. You know...1 and 2. This situation was the most dreadful situation...but bite was on and it was a long paddle back. Plus I knew that surfing the waves back in would probably cause me to go anyway.
I had to get creative and used my bait bucket
All of my experience as a martial artist had to come into play...Balance, Concentration, and Confidence LOL. Just had to make sure no one was around..though, my friends never let me forget it. It was a good learning experience, because they both used the same technique
Now, those were only three times...I have been kayaking since 2005. Most of the time, I try to ensure to practice preventive measures...know your patterns, know your diet, and most of all...know your a$$