Yup, that sounds exactly what I have, just on the opposite bank.

I can hear something knocking/slapping. Not sure if something is broken, or if that is just the sound of a cylinder with no ignition.

If I clear the CEL, it will idle without flashing, but with any load it will start the blink.

 

Update:

Was able to remove the coil pack with ease. I was lucky. This was not the original and whoever installed the last one did not use the lower bolts. I had to mess with it a bit but it came out.
Installed the new coil pack today. Took roughly an hour to install and re connect the plugs. The truck is running smooth and no misfire codes. I've driven it for about 40 minutes so far and all good.

Put new front 02 sensors in and now i've got p0150, probably didn't plug the sensor in properly. i'll deal with that later. Was very happy to have fixed the misfire issue.

Honestly If you can get your hands in and change the plug wires you can also get in there to change the entire coil pack.

One thing I thought was strange. When I installed the new coil pack the lower bolt holes where no where near lining up, even with the 2 top ones tightened all the way. I'm not sure what that means.

so to answer anyones question as to whether it can be done without removing the top end...YES it can.