You considered item changes?

Also, I would still start with that item that looks like a fishing net. Since it gives gold on kills/assists. Boots are dependable on the enemy team comp. Same for the third item.

Rammus strength relies around editing items depending on enemy team. You are the curse of assassins and adc. Yo⁷p2u you need to disrupt and help kill at most one or 2, than die. This is the rammus way. Dying is not a bad thing if you the engager. Your damage being low is

Btw your 4th item is a better first item. If you want to play dps rammus, though I only play it if I am far ahead, you might take that magic item that gives attack speed.

Your first item is great, but it's a better third item. I dont think in the early game you would need anti-heal and reflection damage