ART AND SCIENCE OF FISTING
Risk management is the process of identifying, analyzing, and handling risks to reduce adverse events that could occur as a result of fisting.
Although each type of fisting presents a unique risks and differing risk profiles, every risk management plan contains similar elements.
Risk management involves identifying risk, assessing tier, and developing resolution options and actions. A risk register is a product of risk management planning.
A risk profile is a quantitative and qualitative analysis of adverse events that could negatively impact an individual. It promotes healthy fisting behaviors by evaluating tolerance levels, identifing risk, analyzing associated threats and dangers, and preventing or preparing for undesired outcomes.
A risk profile contains the following:
A risk profile contains a tolerance declaration, list of risks, an impact assessement for each risk, and resolutions or plans for each risk. Typically, a list register combines the individual risks, their impact assessments, and their designated plans.
Tolerance identifies your overall comfort level with (1) adverse events occurring during play and (2) the severity of harm from said events. A low tolerance level means you implement all the prevention strategies identified in your management plan. A high tolerance level means your management plan will focus primarily on mitigating high severity risks.
For example, and fister with a high tolerance level will not concern himself with infection transmission, microtearing, or minor hemorrhoids. His risk management plans will focus heavily on serious injury or conditions that may affect his ability to fist.
A personal assessment considers tolerance levels for physical injury and emotional discomfort. Physical injury includes the onset or exacerbation of a condition affecting the hole. Emotional discomfort encompasses two things: psychological harm from inappropriate or malaligned interactions (including sexual violence), and lingering depression or identity crises resulting from a physical injury that prevents fisting or changes the type or intensity of fisting one can enjoy.
Two questions should be asked during the personal assessment:
Can I handle the physical repercussions if I am injured or sick?
Repercussions typically include time off from work, lengthy hospital stays, emergency surgeries, physical limitations, physical discomfort (major/minor), aggravation of existing conditions, and altered body function.
Can I handle the ensuing emotional instability related to a traumatic event?
Psychosocial considerations include injury disclosure to family and friends (resulting in outing as a fister), financial stress, identity crises, PTSD, intimacy and trust issues, and depression.
Once you have addressed those two questions, you can then document your tolerance declaration and continue with developing risk management plans.
Completion of a tolerance declaration helps you understand comfort levels with physical, psychological, and social consequences of risks. An ambulance trip may result in nosy neighbors asking embarrassing questions.
Your tolerance declaration contains the acceptable margin of variation, limit of endurance, or boundary threshold within which you can function properly in fisting and non-fisting contexts. It can be structured and formal or very informal.
Tolerance Level – Adverse Physical Events:
High
Tolerance Level – Adverse Psychosocial Events:
N/A
Adverse Events to Consider:
I am willing to accept and am capable of handling the financial loss, social implications, physical limitations (temporary or permanent), and emotional duress associated with a major fisting injury (such as perforation) or sexual assault.
My mitigation aims at accepting the probability but reducing the impact of high severity items. As I am capable of handling emotional trauma, my risk management does not include issues associated with emotional well being.
Tolerance declarations direct future risk management plans by identifying comfort levels with consequences of adverse events.
A heat map, also known as an impact matrix, is a tool that provides a standardized method for classifying risk based on probability and severity. During the development of a risk management plan, each identified risk is plotted on the matrix. The resulting risk tier is then compared against the individual's tolerance declaration to determine whether additional controls are warranted.
Probability
Severity
A five-level impact matrix rates probability of occurrence from extremely likely to extremely unlikely, and severity from not consequential to catastrophic.
Risks with high severity and high probability pose the greatest danger and fall within a danger zone, usually shown in red. Risks with low severity and low probability pose little danger and fall within a zone of disregard, shown in green. Yellow and orange represent risks with varying degrees of severity and probability.
A risk register lists all of the relevant adverse events a fister may encounter during or after a fisting session. After risks are identified, they should be categorized, assessed for probability and severity, and prioritized accordingly. Avoidance and mitigation plans can then be drafted for significant risks. Typically, on risks that fall into yellow, orange, and red designations need plans.
Risk identification involves conglomerating a list of adverse outcomes (risks) including injuries, medical complications, exacerbations of existing conditions, and psychological challenges associated with an activity.
Common risks included in risk management plans for fisting include:
Risk analysis is the evaluation of identified risks to determine appropriate courses of action. In project management, there are four types of actions to take with regards to identified risks: accept, transfer, avoid, and reduce (mitigate). Fisting and fisting adjacent activities (including toy play and pegging) disregard the first two and focus on the latter two:
Avoidance | Risk planning sets guidelines and bondaries so that the risk does not occur.
An example of avoidance is eliminating the use of firm, slender toys in any type of play to prevent perforation.
Reduction | Risk planning creates action plans to reduce the impact when an unwanted event occurs.
An example of reduction is creating response plan that direct activities after a potential perforation. Delaying examination and treatment can be fatal, so a directive prevents deadly outcomes.
Risk analysis combines risk assessment and risk multipliers to determine which risks should be addressed in risk management plans.
Risk assessment calculates the magnitude of an adverse event based on probability of occurrence and the impact severity.
Some risks are very common but have minor impact, and mitigation strategies may be left undefined. Other risks are rare but potentially life-altering and may require substantial avoidance and reduction strategies.
Assessment calculators can determine the risk's magnitude: low risk, moderate risk, high risk, or extreme risk. A caculation tool isn't necessary to determine magnitude. Magnitude can be set/determined by a fisters own reasoning or rationale.
A heat map/impact matrix is an alternative to an assessment calculation tool. The heat map uses the same logic as a calculation tool, but allows an individual some override capabilities. Heat maps and calculation tools are often used with risk tolerance declarations to determine which risks need additional or advanced planning and which risks can be disregarded in a mitigation strategy.
Template: Heat Map / Impact Matrix (Spreadsheet)
An assessment calculator uses internal logic to evaluate a risk's magnitude.
After the magnitude of a risk is established, management plans can be developed. Mitigation or avoidance plans for low risk items are often abandoned at this stage, even when a risk multiplier is considered. For example, microtearing is common during basic/elementary fisting but it is usually low impact—typically, no mitigation or avoidance plans are needed. On the other hand, perforation during depth play is uncommon but may result in emergency surgery or death—avoidance and impact reduction plans are necessary.
Risk multipliers are activities or situations that amplify the severity or probability of an adverse event occuring. The three most common multipliers include:
Select a risk multiplier:
Fisting carries risks, but when other factors are included with fisting activities, adverse events become more likely and more severe. This chart shows shifting risk assessments based on the selected multiplier.
Avoidance and mitigation plans are part of the risk profile. Avoidance plans are often self-explanatory: DO NOT DO [ SPECIFIC ACTION OR ACTIVITY ]. Mitigation plans can be more complex with strategic considerations and communications directives.
Plans can be very unique to individuals based on tolerance declarations, allowable risks, and multipliers. Common elements associated with injuires, complications, exacerbations, and pyschosocial ramifications should be considered while drafting plans.
Minor injuries may not need any medical interventions but rather time to heal. These injuries include bruising, microtears, small fissures, hemorrhoidal bleeding, hemorrhoids, and certain STIs.
Major injuries can result in ongoing discomfort, residual pain, lingering infection, invasive surgery, and even death (when appropriate treatment is not provided in a timely manner). These injuries include tears, fissures, advanced hemorrhoids, perforations, and certain STIs.
Mitigation plans for minor injuries include implementing standard practices while fisting, conducting regular STI testing, speaking freely with healthcare providers, observing periods of sexual abstinence, utilizing prescription and OTC drugs, and limiting use of illegal substances. Mitigation plans for major injuries include similar interventions used for minor injuries, but also immediate medical evaluation and treatment.
Perforations, tears, and certain STIs can result in sepsis, a medical condition where an infection quickly spreads through the body and can result in total organ failure and death in less than 48 hours.
Severe injuries, such as perforations, require surgery. Surgical plans should be discussed with your care team in advance of the procedure.
Most complications from fisting and fisting related activities result in temporary illness or discomfort. Examples include tenesmus, a condition often described as a pulsating anus where it feels like a bowel movement is needed, but none can be produced.
Certain medical conditions can be made worse by fisting. The most common of these conditions are bowel related (IBS, Chron’s disease, diverticulitis, etc.), but other body systems can also be detrimentally affected.
Mitigation plans for complications usually mimic those of minor injuries: regular STI testing, abstinence/resting periods, prescription or over-the-counter medications, or other comfort care activities.
Mitigation plans for medical conditions may be minor or major. Plans may focus on lifestyle changes and developing coping skills for chronic health conditions. Plans might also include surgeries to address issues that don't respond to non-invasive treatements.
Tenesmus is a condition frequently described as fisters where "It feels like you have to go, but nothing comes out."
For anyone who identifies as a fister, a disruption to fisting can be an extremely traumatic and destabilizing event. Avoidance and mitigation planning may include:
Therapy provided after an injury can help in the development of coping skills and identity realignment.
Mitigation plans should contain a communication directive.
Fisters should always share these details with their providers in emergency situations:
In the event of a medical emergency, it is extremely important to be up front with the care team immediately. A fister that forces a doctor to play detective wastes valuable time and increases the likelihood of extremely poor outcomes.
Activity | Providing details regarding the actions resulting in the injury helps medical professionals assess the severity of an injury.
For example, a fister who was injured in a session with high intensity, deep, double punches has a higher probability of life-threatening injury than a fister who was engaged in elementary/basic fisting.
Medical teams know very little about fisting and fisting jargon, so specific terms and fisting activity details may need to explained thoroughly.
Personal Significance | Discussing the significance of ass play and fisting in one’s life with physicians or surgeons may influence the care plan and surgical interventions used to treat injuries.
For example, when HungerFF, a well known porn star and fisting influencer perforated his colon, the first medical team he spoke with told him that he would no longer be able to fist or prolapse after reparative surgery. They did not realize how his life and brand are focused around his prolapse and were hesitant to consider alternative options.
A communication plan should consider privacy issues related to the injury.
First, during a hospitalization, a fister may be accompanied by friends or family. Disclosing details to medical professionals in front of these individuals may reveal very private and potentially embarrassing information. It may be necessary to ask family or friends to leave the room when speaking to practitioners. This can be difficult or awkward. Injured fisters should be mentally prepared for this situation.
Second, during recovery, a fister’s lifestyle may change in very observable ways. For example, an ostomy bag may require clothing changes or withdrawal from events where the bag cannot be concealed.
The privacy component of a communication plan should address how these situations should be handled. Some choose to be up-front with family, friends, and employers. Others choose to create and maintain a cover story.
When family members are present in a hospital room, discussing sensitive or embarrassing issues may be difficult.
Fist Theory provides detailed risk management plans for the four categories of fisting (elementary/basic play, depth play, punch play, and width/stretch play) as well as mitigation plans for toy play.
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Course Appendix
The following material may guide the development and deployment of this topic:
Upon completing this course, the student will be able to:
Note: Objectives should follow instructional design standards and be easily measurable with little ambiguity.
These individuals have indicated they continue fisting with this condition:
