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As someone who gets paid in Bitcoin and only has Bitcoin I can explain how it works.

I make purchases using Bitcoin or credit cards. I then sell enough Bitcoin to pay the credit card bills.

When you buy a pizza for $20 when does the FX transaction happen, at purchase time or at the time you pay your credit card bill?

I would hate to be on the hook for btc denominated loan.

When I pay my credit car bill. With my San Francisco software engineer salary the FX risk of that $20 is acceptable.