That's it. Looks pretty bad.

 

I'll try to get in there with a toothbrush and some air. How would I know if it's so bad it needs to be replaced?

 

It wouldn't run at all or it would run, heat up, die, run again when cool, die, repeat.

It's solid state, epoxy potted. There are tests, but...

Best thing is a stiff paint brush, contact cleaner for electronics & compressed air.

It can get you by. If not, item above + pressing off gear.

I had a local shop do it for less than $20 about 12 years ago & I supplied the PIP.

 

Well I tried to clean the pip today, but I still have the issue, so I'm guessing either 1) I didn't clean it well enough, 2) that's not my core issue or 3) it is broke beyond cleaning.

​​Also just to clarify for anyone reading the issue is now:
1. Truck seems to start a little rough, but starts first try
2. Idles way up until something seems to catch it and bring it back down.
3. From there the truck runs fine as long as it's on (I even used it for some work around the yard today)
4. After it's shut off I can't get it to start back until the next day.

If that still sounds like the pip I may try to figure out how to replace it, or look at replacing the whole distributor.

 

1. Truck seems to start a little rough, but starts first try---thiis won't help the no start, but maybe the, rough running, how long since tune-up done, plugs, wires, cap and rotor
2. Idles way up until something seems to catch it and bring it back down.--it should do this each time you start it, part of fast idle, then settles down to normal idle, if cold out, it takes longer to idle down
3. From there the truck runs fine as long as it's on (I even used it for some work around the yard today)
4. After it's shut off I can't get it to start back until the next day.-- before you pull PCM and open it up, you can try, testing the ICM, and PIP, test these only, when it don't start back up,
Part 1 -How to Test the Ford Ignition Control Module (Fender Mounted) -- how to test ICM
Part 5 -How to Test the Ford Ignition Control Module (Fender Mounted) -- how to test PIP, scroll down to test #7

when testing your ICM check to see if the #'s on it match any below, PO could have changed it out, but parts stores have the wrong ICM listed for our 94 and up trucks

most everyone, suggest using motorcraft only

 

Well all I'm happy to report I think the truck is fixed. And while I appreciate everyone's suggestions, it ended up being the electric coolant temperature sensor.

​​​​while working on everything everyone suggested, I also started looking at the only code I could get, which was 116 (out of range engine coolant temperature sensor) . At first I ignored it thinking it wouldn't cause an issue like this, but then I found a video with a guy explaining that the truck starts the first time thinking it's super cold outside. It then runs decent, but if you turn it off and back on it still thinks the engine is super cold and floods it when it tries to start again. The sensor was super easy to get to and fell apart in my hand. I put one on this morning and have started the truck 5 times today and every time it started right up, better than any time since it broke.

Thanks again all!