My last TV was a F-250 diesel, 6-speed manual. I had the exhaust brake installed anticipating a lot of driving in the Rockies. I am very glad I did. I have crossed the Rockies over 1/2 dozen times in the past 4 years. The exhaust brake worked well enough that when I had the 100,000 mile service done, the brakes on the TV looked like they were just barely broken in.
The F-350 I have now is an automatic with tow/haul. I plan to have an exhaust brake installed as soon as my budget allows. I often tow utility trailers, and a boat trailer while the Montana is parked. The exhaust brake is part of my driving technique.