Holy ****, 531k, congrats.
Sounds like your trans is losing 3rd/4th, first OD goes, then 3rd.
I had a '95 Burb C1500 that went 340k on the original trans before it blew a seal and lost all the fluid.
What would probably bring back OD would be some Lucas Stop Slip, it might prolong the life of your trans quite a bit.
At 325k, my trans had a harsh shift flare going into 3rd, so I poured in 2 bottles of lucas along with changing the fluid, and it lasted another 15k (I even drove most of the way across the country with it that way). It probably would have went further if I had the foresight to replace the rear bushing/seal, or have it towed instead of limping it 300 miles home.