First off, welcome.
Is the truck stock? Ever been tuned, aftermarket air intake, etc? Knowing what has been done to your truck can help us diagnose it.
Getting down on power then becoming hard to start is pretty common when the injectors or CP3 are getting toward end of life. Most CP3s seems to go farther than 250k miles (especially if the truck has never been tuned), but I have seen some let go at lower miles than you by far.
You will want to get a scan tool and log rail pressure, both actual and desired. They should be within a few percent of each other, even at full throttle. If not, that is the cause of low power & smoke.
Figuring out whether it is the injectors or CP3 (or both) that are worn out and causing the low pressure is a harder job, especially on the LB7. The official method is to remove the valve covers and do a return rate test. If the injectors are that old, I'd put odds on them being the culprit.
If you do replace them, get good remans on Bosch cores from a reputable dealer, or you will be doing the job again soon. Lincoln Diesel Specialties is one such vendor, and last time I bought injectors through them they had the best price and genuine Bosch cores. I highly recommend them, but there are others that will get you good stuff too.