it almost dies out after starting and as start to pull out seems like it wants to die rough idle
If yo are only having trouble at idle, I would suspect the idle air controller is malfunctioning. However, that assumes that regular maintenance is up to date and the engine is in good overall condition.
My guess having owned 3 of these trucks is it needs a general tune up. New plugs, wires, distributor cap, rotor button and an ignition coil. Could also need a fuel filter.