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My 99 F350 just got the Tru-cool Max cooler put back in it yesterday. I had a 9" electric fan behind the cooler that came with the truck, but my temps would climb to just above 200* and I'd have to let it idle a bit and cool off. The early 99 Super Duty trucks didn't have the oil-to-water cooler, so all I have for tranny cooling is the oil-to-air.
When I put the Tru-cool back in, I also put twin 7" fans behind it. After starting the truck (Still warm from driving) I could feel an amazing temperature difference between the two ends of the cooler.
I also just got 6 gallons of synthetic tranny fluid for it. The synthetic is better able to handle higher temps, without breaking down. Trackspeeder on here, is the guy that pointed me to the Tru-cool Max.. It's rated for a 40,000lb GCW