Adam was dying in a coma. Tommy was pregnant, but in reality the doctors had not told him that he was actually giving birth to a hotdog.
Adam was not actually in a coma but he had severe gastritis from too much sex. Unfortunately Mr Lamberts butt has been blocked from excessive sex causing him to going into a coma, the doctor had told Tommy.
Ever since GNT had ended the whole glam troupe had gone off the rails. Monte became a street walker and Isaac raped Tommy hence the reason he is pregnant. Now I know that you're what you are thinking how can he be pregnant with a hotdog...? But the actual fact is Isaacs's grandmother was nothing but a hotdog.
Not only this but the whole group had become rather religious so to speak. Tommy had turned to god and become a nun, whilst Neil was a Priest in training. But our Tommy is not one to resist any temptation so he grabbed the opportunity with both hands and nth legs O_o and cheated on Adam with his brother Neil.
So the moral of the story is when one brother's butt is busted you don't waste your time and move on to the other one.