Poorly :/ I'm fairly nomadic, and it's a struggle to even keep a debit card that works globally, let alone optimize banking fees and exchange margins. My bills are in 3 different currencies. My backpack is cluttered with change, in currencies that I am unlikely to use anytime soon, but in quantities that make exchanging them pointless.
I really can't wait for digital currencies to penetrate further into mainstream.
Thanks for asking, hopefully I'll spot some good tips here.