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It all started out with the part close to his gills getting lighter and now I noticed that he has a little lump. I can see the lump underneath him and on his side. He has been eating less like before (he has just gained his appetite a month ago and then lost it again). What should I do?

This book is very nice, but I don't get it. How did Alex become Adam at the ending? Please answer. Anyone who's read this book and answers would be greatly appreciated.