Thanks for all the replies.
I know a lot of you have suggested to get a professional fitting and I do think that it is sound advice. I'm planning on getting a new bike within the next 45 days or so. I'm waiting for the Canyon Ultimate to become available. (Allegedly ~45 days from today.) At that point I'm selling the Specialized. So I'd like to see what I can accomplish on my own in terms of fitting the bike.
I "restarted" riding road in mid-June. I got about 450 miles until this past weekend. No pain in my hands or elbows or anywhere else. Occasional hand tingling, but nothing a good shake didn't resolve. So that setup didn't hurt me. But it wasn't very aero.
This past weekend, I changed my setup. I did a 20 miler, no problem. I did the 40 miler and the irritation in my hands was noticeable. My left elbow didn't feel great after the ride. Tingling on the medial side. I decided not to ride Monday and today. The elbow pain /tingling is settling down. I can still feel some slight tingling in my pinky and ring finger.
Others here have suggested moving my seat up on the rails. I'll give that a shot.
Another idea is flipping the stem to the less aero position and removing some of the spacers below it. So instead of dropping the handlebar stack 22mm, I'll shoot for 11mm.