here’s an alternative/non cataclysm setup that was used and hailed for a while (he switched to cataclysm later)
https://forums.crateentertainment.com/t/1-1-9-6-king-trozan-4-24-crucible-gladiator-150-170-shard-100-all-celestials-cold-caster-druid-by-mad-lee-vid-g4-everything/
if you notice even there that was a rather “stark” contrast in the sustain/survival elements vs yours, more regen and heal procs etc
and ofc as ya1 already mentioned, not having seal of skies means you get to sustain even less, specially when ghoul procs