Hi everyone. I wanted to share the combination of tricks that have helped me work through two nasty fissures and return to a relatively normal life.
Of course, everyone's experience will be different and if this doesn't help you, I am truly sorry. My goal in sharing this is that I will be able to help at least one person.
Quick review of my story - I developed my first fissure in July of 2011 while on vacation. Typical circumstances. I was traveling, got constipated and made a small tear. I felt pain from time to time when I would go to the bathroom, but it was never consistent so I didn't do anything for months. That fall, during my physical, I mentioned the pain to my doctor who prescribed Dilatizem and a high fiber diet. The pain came and went over the ensuing months. I ultimately learned some things I was doing - rigorous weight lifting, not enough water, not enough fiber, etc. - were aggravating the situation.
In the summer of 2012, a combination of massive work stress, horrible diet and zero exercise turned my insides into a nightmare. Diarrhea constantly. Too much caffeine. No veggies. No fiber. The pain got worse and worse. I told myself that, if I could get to the end of the summer, I would focus on my diet and heal up. Unfortunately, by that point the pain wasn't leaving. I'd spend hours each night after a movement lying on my stomach or in the tub. I went to see two specialists.
The first was a moron. He prescribed tetracaine which did nothing but make the burn worse, and demanded an immediate colonoscopy. I went to doctor number two for a second opinion and he gave me a much different prescription:
Konsyl - fiber supplement in water every morning.
Water - lots of it, and ideally 20-30 ounces right after I woke up
Desitin - now this surprised me. The diaper rash cream applied as needed.
Diet - a dramatic shift. Cutting down / out caffeine, sugar and dairy. Focusing on fresh veggies, high fiber foods, etc.
Stress - I had to learn to calm down at work.
That was in September. Today, I believe I'm as close to normal as I ever may be again. Movements are pain free except in the rare occasion when i lose focus and either constipate myself or trigger diarhea. I continue to take Konsyl every morning, I'm back in the gym lifting weights. I feel like I have my life back.
I do stillc arry a tube of extra strength Desitin in my briefcase and I am always worried about a retear, but each day that goes by I feel more and more convinced that things are looking up.
I hope this helps!

Thanks a lot for sharing your story. After researching extensively on the internet, I believe it is your diet ultimately that helps.

Great to hear your success PortlandGuy.
I hope your first fissure of 2011 will not haunt you down later in life.
Some times AFs can seem like mice, if you see one, you may have 20 others lurking underneath your skin, ready for you to slip up.
Don't let yourself go now. Birthdays and other holidays will be there to challenge you and your diet.
I too am enjoying almost a two year remission of my AFs.
Thanks for your encouraging words.