I'll take a stab at outlining what is needed on both the server and client sides:
Client:
1. Install EQ Titanium - no patching!
2. Modify eqhost.ini to direct to my EXTERNAL IP address, port 5999.
3. Modify EQ Shortcut to add "patchme" switch.
4. Determine their EXTERNAL IP, using
http://whatismyipaddress.com/ or similar tool and communicate that to server admin.
Server:
1. Determine my EXTERNAL IP, in similar fashion to client above, and communicate to client.
2. Add name of external account and their IP address to the account table in PEQ database.
3. Forward port 5999, 700X, etc. to server machine local IP in router.
Is it really that simple?