Just go and eat - but also don't expect to eat in 45 minutes. Dinner should be three hours minimum - and is largely the point of the whole day.
As to the 'acting American' thing - I go every year, with a bunch of Americans. Only one guy ever had a problem, and he was the guy who wanted everything to be like at home, who got furstrated that people didn't speak English, and thought everything should happen more quickly. My guess, from your postings, is that you aren't going to fall into that trap.
But the best bit of advice I could give you is: ask the waiters what they think you should have to eat (unless you're in tourist trap places, where they won't care). This has two benefits: firstly, the waiters will love you, which is invaluable; and secondly, you'll get the best food. It's much more region-specific in italy than almost anywhere else in Europe, and it makes a difference, belive me. I mean - a country where nearly every village has it's distinctive style of bread?
Places I wouldn't want to miss (not previously mentioned): Napoli - just a mad town (and home of Pizza); Gardone Riviera (sp?), if you're going to be up near Como; and there's a bar in milan that serves gin and Tonic in pint glasses, but I can't remember it's name (surprise).
E
PS. Oh, and it's cheap.
PPS. For the best ice-cream, check out the colour of the Banana flavour - if it's yellow, don't touch it (its coloured) - it should be grey - then you're OK.
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