Shudder / Misfire / Rough idle / white smoke

[Voo_Doo]

Like the title says!

2004 f350 6.0 supercab shortbed srw
122K. Had ficm repaired about 2000mi ago and it had been running really nice and strong but had lots of white smoke especially when cold and would go thru a lot of coolant. It didnt bother me much so I basically ignored it especially because it ran so nice otherwise. Just changed the oil about 150mi ago. I'd put in a jug of full strength coolant about once every 6weeks.

Drove it to work this morning (42mi) ran great. Truck sat in the parking lot all day 8hrs in 25-30degree temps.
Got in it tonight to come home and found it running like complete crap. Really hard rough idle to the point it shakes the cab strongly. Feels like a popping or misfiring. As i limped it home, The severity of the shuddering seemed to come and go depending on the RPM. Right at 1500 seemed to be the worst of it. Shaking really hard to the point I debated pulling over and considering a tow home.
Oddly, putting it in tow haul mode seemed to smooth it out a bit. I was thinking it was due to keeping it in higher RPMs so probably talking about injector issue? It is also smoking thick heavy white smoke that has a strong fuel smell.

I understand injectors, egr and head gasket are all potential causes but how do I tell which it is for sure without throwing parts at it?
As always , any help is very much appreciated guys.
Thanks in advance


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[04cr450]

take the egr valve out and look down in the intake.. If it is wet or moist. Thats your problem.. Thats what it sounds like to be honest.. Egr cooler is blown. Check that first due to that being the easiest report back