To be truthful I really don't know. If you got an AE or scanner you can see if you are throwing injector codes. Rough idle and white smoke make me think injector. They arent too bad price wise. $300 a piece iirc.
So are you around the Bowling Green Area? Just trying to figure out whats an hour north of St. Louis? I don't know many guys that do much to the 6.'s around this area.
I had to check your location ... thought I might have seen you yesterday.... but it was another truck with issues........ I was trying to catch up with him to let him know he had a blown headgasket and to stop driving it before he did more harm, but he kept limping and smoking along. I guess it would stop smoking when it finally ran out of coolant right?