If the EGR system is not taken care of then blown headgaskets are going to happen. When the coolant system clogs, it causes oil and coolant temps to rise, which causes the engine to run hot and blow the gaskets.
I recently bought a 2003 Excursion with 197k miles, it is a very good running engine, but I plan to fix the EGR system the right way, which is to cut it completely off and weld up the holes on the intake manifold so that coolant doesn't even flow through it. I just put a 4" turbo-back exhaust on today, even on a performance tune the boost pressure never got as high as with the stock exhaust (only ~21 vs. ~25, that tells me it is running cooler (I plan to put an EGT gauge on it). Once I get my new manifold modified (bought one on ebay), I plan to do head studs and gaskets just as a precaution since I do plan to tow with it.
I will recommend Scott @ Trucks Unlimited, but he is a good drive for you, just south of Winston-Salem.