I agree with Trainmaster about diagnosing. I have done a good deal of "diagnose by replacement". Sometimes you get lucky and sometimes it's a royal waste of money. I had a similar issue on my 2000 Expy 5.4 on hills only. It was over 290K and I had the original coils. Changed plugs and coils and problem went away. My son's '07 F150 4.6 had the same issue - only hills. I started down the list of possible culprits based on the codes by doing the cheapest and easiest first. First I cleaned the MAF. No change. Then I bought the right upstream O2 sensor and the fuel rail pressure sensor. When I pulled the old fuel rail pressure sensor I saw that o-ring had separate into two torn o-rings and knew that was almost certainly my issue. Since I had already bought them I replaced the fuel rail pressure sensor and the O2 sensor anyway, but I would say with 95% certainty my problem was a $1 o-ring. (The closest hills of decent size are at least 85 miles so test driving after just replacing the o-ring was not practical.) The problem was now gone and has stayed gone. You have to put a little lube on those fuel rail pressure o-rings or they will tear when you seat the sensor. Are any of these going to cure bobross' problem? I have no idea. I just got lucky. But if I'd taken it to a dealer they would have charged me more than twice as much as what both the O2 sensor and fuel sensor cost just to diagnose the problem. And I'll bet they would have managed to find something a lot more expensive wrong than a $1 o-ring that took me 5 minutes to change. That said, I did chase a vacuum leak on the 2000 Expy for about six months at around 200K. I changed plenty of hoses, valves, and even the brake booster because I was convinced they were the source of the leak. They weren't. I finally took it into Ford for analysis. Turned out to be a crack in the intake manifold back near the firewall where I never would have found it. Friggin plastic intake manifolds... The 2000 Expy has 315K on it now.