While engine is running, open the cover where you add oil to engine and see if you see a good flow of oil, if good flow, could be as easy as replacing oil sending sensor. got to realize that if poor maintenance history your engine may not be building enough pressure at iddle to move your hydraulic operated valves, only when you rev it up it will pump enough to run smooth. if running engine too long, you may cause more damage to other engine components such as crankshaft and cam shaft bearings. if you can spare a few bucks, have a good mechanic check your oil pressure with a mechanical gauge. another cheap option is to replace oil pump. last resort if you love your truck as much as we do,replace engine or rebuild it. At 205,000 this is a normal symptom, other than timing chain problems, most engines don't make it that far. hope this helps!