Has Anyone Used Bitcoin or Other Cryptocurrencies as a Medium of Exchange?

I saw an mainstream ad for a debit card to access Bitcoin funds.  I imagined it being a little like travelling and they ask if they want you to hit the card in their currency or in USD at the store's exchange rate.  I've always found my card gives a favorable exchange rate.  

 

My question is whether anyone is using Bitcoin for trade.  Have you known of someone offering to clean out the eavestroughs, for example, for 3 mBTC?  

 

I'm intrigued by the concept of cryptocurrencies, but it seems like for them to be "currencies" people will have to use them as a medium of exchange for legitimate trades.  Is that happening?  If so, is anyone earning them and spending them without promptly converting them back to a state-backed currency like USD?