I ride so fast, the patches throw off the whole balance of my wheel.
For my last two flats, the opening was where the Presta stem met the tube. No good way to patch that. Those were the factory tubes. I haven't had this problem with the aftermarket tubes.
For punctures, I'd probably go 2 or 3 before replacing it.
On the other hand, remember that the tube is double-thick at the patch locations, so they actually become more durable.