Wait- so if you open up your exhaust, the motor pulls air back in through the exhaust valves? Please explain how this is possible...
Please stop posting about back pressure- it is a myth that doesn't apply to modern EFI motors the same way it applied to old carb motors. While changing exhaust components will affect engine performance, it is not because "your motor needs backpressure" to run right.
OP- It could be any number of things affecting your HP at this point. With added miles comes added things that can go wrong- not necessarily enough to get a CEL but enough to affect the HP/TQ your motor is making. Also- putting mods on the truck will also have an affect on things as well. Running almost an 'open exhaust' such as you have is going to impact your torque/hp curve and if you don't have an appropriate tune to compensate you are going to lose power. Your motor does NOT need backpressure to run properly- it is set to run with the flow capabilities from the factory. Change those parameters and your tune should be changed as well.
There are pages that could be typed on the topic. But anyone who claims your motor needs "backpressure" to run right doesn't understand exhaust dynamics and how they apply to how a motor operates.
I would recommend ditching the tuner you have now- get a quality tune from a source such Blackbear and tell them what exhaust system you decide to go with. As far as exhaust it is personal preference- but I would go with some long-tubes, high-flow cats (to help smooth out sound and clean up the smell) and a 'cat-back' of your liking. A 3" cat-back isn't going to be overkill IMO for a 5.3 and give you a little room to grow if you decide to swap out heads or cam down the road.
Did he adjust his tune at all? What other mods were there? And if someone is running open headers I doubt they are just driving around like grandma on a Sunday cruise...Also- the whole "I knew a guy" doesn't count as personal experience in my book.