Just a heads-up my truck doesn't have EGR so that's one less potential issue.
I'll post up a video of it running later today. If a cam lobe was bad it would be a consistent misfire on one cylinder right? This is more of a momentary thing where it idles mostly smooth for a few seconds then drops and "chugs" like it lost multiple cylinders, and the process repeats. I'll hook up my vacuum gauge and show that in the video too.
