Well I have tested everything and I finally bought myself I nice borescop that can swivel. Looks like every exhaust valve is barely kissing the pistons. Seems pretty obvious. I'm guessing something in timing cover has failed and now truck is out of time causing the issue. Every exhaust valve looks like this and every exhaust relief in piston has a shiny spot.
Sent from my Pixel 6 Pro using Tapatalk


Sent from my Pixel 6 Pro using Tapatalk